With all the recent attention on trial designs, you have to wonder at Merck's decision (below) to compare Arcoxia to diclofenac. Cardiologists have long been aware that the drug diclofenac is linked to increased cardiology risks. Given that Arcoxia is a Cox-2 inhibitor, a class of drugs that has created a financial disaster and public relations nightmare for Merck, researchers must have known that all of the data being presented for it would be put under a microscope. Merck's new CEO has been working long and hard to overcome the public's negative perceptions spurred by Vioxx. Presumably, this trial was in the works long before he gained the helm. Arcoxia now will be given even closer scrutiny, if that's possible. None of it spells good news for Merck. - John Carroll