A study published in The Lancet examined celecoxib use versus naproxen in patients with cardiothrombotic diseases and arthritis.
Francis K. L. Chan, MD, of the Chinese University of Hong Kong, and colleagues conducted an industry-independent, double-blind, double-dummy randomized trial in a Hong Kong hospital.
Researchers enrolled 514 patients, assigning patients randomly to receive either celecoxib twice per day; esomeprazole once per day; or naproxen twice per day with esomeprazole once per day. All patients received aspirin once per day. Researchers measured recurrent upper GI bleeding within 18 months as the primary endpoint.
Here's what they found.
1. Of the 514 patients, recurrent bleeding occurred in 14 celecoxib patients and 31 naproxen patients.
2. Cumulative recurrent bleeding incidence rate was 5.6 percent in naproxen patients
3. Excluding patients who reached the study endpoints, 21 celecoxib patients and 17 naproxen patients had adverse events leading to treatment discontinuation.
4. No treatment-related deaths occurred.
Researchers concluded, "In patients at high risk of both cardiovascular and gastrointestinal events who require concomitant aspirin and NSAID, celecoxib plus proton-pump inhibitor is the preferred treatment to reduce the risk of recurrent upper gastrointestinal bleeding. Naproxen should be avoided despite its perceived cardiovascular safety."