Randomised clinical trial: gastrointestinal events in arthritis patients treated with celecoxib, ibuprofen or naproxen in the PRECISION trial

Abstract

Arthritis patients taking NSAIDs plus esomeprazole have infrequent clinically significant gastrointestinal events. Co-prescribed with esomeprazole, celecoxib has better overall GI safety than ibuprofen or naproxen at these doses, despite treatment with low-dose aspirin or corticosteroids.

Ibuprofen Safety at the Golden Anniversary: Are all NSAIDs the Same? A Narrative Review

“…The PRECISION clinical trial mentioned earlier was a double-blind controlled study of 24,081 OA or RA patients who required NSAID analgesic therapy [46]. Patients were randomized into one of three groups: celecoxib 100 or 200 mg twice daily, ibuprofen 600-800 mg three times daily, or naproxen 375-500 mg twice daily.…”

How effective is the average therapeutic dose of a nonsteroidal anti-inflammatory drug in osteoarthritis?

“…Еще большей оказалась разница в отношении патологии верхних отделов ЖКТ (так называемые Clinical Significant Gastrointestinal Event, CSGIE -кровотечения, обструкция, перфорации или клинически выраженные язвы): 0,34; 0,74 и 0,66% соответственно (p<0,001). Это особенно важно, поскольку все больные получали гастропротективную терапию ингибиторами протонной помпы (эзомепразол) [7].…”

Editorial: gastrointestinal safety of COX‐2 selective and nonselective NSAIDs—the impact of the PRECISION trial

“…In a recent issue of AP&T, Yeomans et al presented a detailed analysis of the GI outcomes in PRECISION . A PPI was provided to all patients and taken by 99% in each treatment group.…”

“…The ITT analysis revealed no difference in clinical GI events between celecoxib and nonselective NSAIDs, although iron deficiency anaemia was less common with celecoxib. Anaemia may be more common than other types of GI clinical events in NSAID users and probably occurs most often from small intestinal injury, especially in patients taking PPIs to reduce gastroduodenal lesions …”