1. PRECISION
Trial design: Patients with arthritis and increased cardiovascular risk were randomized to celecoxib 100 mg twice daily (n = 8,072) vs. ibuprofen 600 mg three times daily (n = 8,040) versus naproxen 375 mg twice daily (n = 7,969).
Results
(p < 0.001)
CV death, MI, or stroke: 2.3% of the celecoxib group vs. 2.7% of the ibuprofen group vs. 2.5% of the naproxen group (HR 0.85, p for noninferiority < for celecoxib versus ibuprofen; HR 0.93, p for noninferiority < for celecoxib vs. naproxen)
GI events: 1.1% for celecoxib, 1.6% for ibuprofen, 1.5% for naproxen (HR 0.65, p = for celecoxib vs. ibuprofen, HR 0.71, p = 0.01 for celecoxib vs. naproxen) %
2.7
2.5
2.3
Conclusions
Among patients with arthritis (osteoarthritis or rheumatoid arthritis) and increased CV risk, modest-dose celecoxib was noninferior to ibuprofen or naproxen in regard to cardiovascular safety
Celecoxib
Ibuprofen
Naproxen
Nissen SE, et al. N Engl J Med 2016;375: