{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T03:29:51Z","timestamp":1792726191429,"version":"4.5.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,3,2]],"date-time":"2022-03-02T00:00:00Z","timestamp":1646179200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007311","name":"Cleveland Clinic","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007311","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most frequently used drugs, both prescribed and over the counter. The long-term cardiovascular safety of NSAIDs in patients with arthritis has engendered controversy. Concerns remain regarding the relative incidence and severity of adverse cardiorenal effects, particularly in arthritis patients with established cardiovascular (CV) disease or risk factors for disease as illustrated by the PRECISION (Prospective Randomized Evaluation of Celecoxib Integrated Safety vs. Ibuprofen Or Naproxen) trial participants (NCT00346216).<\/jats:p>\n                  <jats:p>We further investigated whether the selective COX-2 Inhibitor celecoxib has a superior cardiorenal safety profile compared with ibuprofen or naproxen in the PRECISION population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Twenty-four thousand eighty-one patients who required NSAIDs for osteoarthritis or rheumatoid arthritis (RA) and had increased CV risk randomly received celecoxib, ibuprofen, or naproxen. The current pre-specified secondary analysis assessed the incidence, severity, and NSAID-related risk of the pre-specified composite cardiorenal outcome (adjudicated renal event, hospitalization for congestive heart failure, or hospitalization for hypertension) in the intention-to-treat (ITT) population. An on-treatment analysis assessed safety in those taking the study medication. Following a mean treatment duration of 20.3 \u00b1 16.0 months and a mean follow-up of 34.1 \u00b1 13.4 months, the primary cardiorenal composite outcome occurred in 423 patients (1.76%) in the ITT population. Of these 423 patients, 118 (28%) were in the celecoxib, 166 (39%) in the ibuprofen, and 139 (33%) in the naproxen group. In a multivariable Cox regression model adjusted for independent clinical variables, celecoxib showed a significantly lower risk compared with ibuprofen [hazard ratio (HR) 0.67, confidence interval (CI) 0.53\u20130.85, P = 0.001) and a trend to lower risk compared with naproxen (HR 0.79, CI 0.61\u20131.00, P = 0.058). In the ITT analysis, clinically significant renal events occurred in 220 patients with events rates of 0.71%, 1.14%, and 0.89% for celecoxib, ibuprofen, and naproxen, respectively (P = 0.052), while in the on-treatment analysis the rates were 0.52%, 0.91%, and 0.78% (P &amp;lt; 0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In the current era, long-term NSAID use was associated with few cardiorenal events in arthritis patients. At the doses studied, celecoxib displayed fewer renal events and hence more favourable cardiovascular safety compared with ibuprofen or naproxen. These results have considerable clinical implications for practitioners managing individuals with chronic arthritis pain and high risk of impaired renal function and\/or heart failure.<\/jats:p>\n                  <jats:p>Clinical Trial Registration: NCT00346216<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcvp\/pvac015","type":"journal-article","created":{"date-parts":[[2022,2,26]],"date-time":"2022-02-26T20:10:03Z","timestamp":1645906203000},"page":"611-621","source":"Crossref","is-referenced-by-count":38,"title":["Cardiorenal risk of celecoxib compared with naproxen or ibuprofen in arthritis patients: insights from the PRECISION trial"],"prefix":"10.1093","volume":"8","author":[{"given":"Slayman","family":"Obeid","sequence":"first","affiliation":[{"name":"University Heart Center, Department of Cardiology, University Hospital, CH-8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Libby","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital, Harvard Medical School , Boston, MA 02115 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine","family":"Husni","sequence":"additional","affiliation":[{"name":"C5, Cleveland Clinic , Cleveland, OH 44195 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiuqing","family":"Wang","sequence":"additional","affiliation":[{"name":"C5, Cleveland Clinic , Cleveland, OH 44195 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa M","family":"Wisniewski","sequence":"additional","affiliation":[{"name":"C5, Cleveland Clinic , Cleveland, OH 44195 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah A","family":"Davey","sequence":"additional","affiliation":[{"name":"C5, Cleveland Clinic , Cleveland, OH 44195 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine E","family":"Wolski","sequence":"additional","affiliation":[{"name":"C5, Cleveland Clinic , Cleveland, OH 44195 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Xia","sequence":"additional","affiliation":[{"name":"Pfizer Inc. , New York, NY 10017 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weihang","family":"Bao","sequence":"additional","affiliation":[{"name":"Pfizer Inc. , New York, NY 10017 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Walker","sequence":"additional","affiliation":[{"name":"Pfizer Inc. , New York, NY 10017 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5972-0596","authenticated-orcid":false,"given":"Frank","family":"Ruschitzka","sequence":"additional","affiliation":[{"name":"University Heart Center, Department of Cardiology, University Hospital, CH-8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven E","family":"Nissen","sequence":"additional","affiliation":[{"name":"C5, Cleveland Clinic , Cleveland, OH 44195 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5259-538X","authenticated-orcid":false,"given":"Thomas F","family":"L\u00fcscher","sequence":"additional","affiliation":[{"name":"Cardiology, Royal Brompton & Harefield Hospitals Trust Imperial College , Sidney Street, SW3 5RN London , UK"},{"name":"Imperial College , SW3 6LY London , UK"},{"name":"Center for Molecular Cardiology, University of Zurich , CH-8952 Schlieren, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,3,2]]},"reference":[{"key":"2022092404481120000_bib1","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1007\/s00296-011-2263-6","article-title":"A turbulent decade for NSAIDs: update on current concepts of classification, epidemiology, comparative efficacy, and toxicity","volume":"32","author":"Conaghan","year":"2012","journal-title":"Rheumatol Int"},{"key":"2022092404481120000_bib2","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.1001\/jama.282.20.1929","article-title":"Adverse upper gastrointestinal effects of rofecoxib compared with NSAIDs","volume":"282","author":"Langman","year":"1999","journal-title":"JAMA"},{"key":"2022092404481120000_bib3","doi-asserted-by":"crossref","first-page":"1520","DOI":"10.1056\/NEJM200011233432103","article-title":"Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. 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