{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T15:53:02Z","timestamp":1789228382782,"version":"build-2803163510"},"reference-count":28,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,4,17]],"date-time":"2018-04-17T00:00:00Z","timestamp":1523923200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2018,6]]},"abstract":"Summary<\/jats:title>\n \n Aim<\/jats:title>\n \n To evaluate\n GI<\/jats:styled-content>\n safety of celecoxib compared with 2 nonselective (ns)\n NSAID<\/jats:styled-content>\n s, as a secondary objective of a large trial examining multiorgan safety.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This randomised, double\u2010blind controlled trial analysed 24 081 patients. Osteoarthritis or rheumatoid arthritis patients, needing ongoing\n NSAID<\/jats:styled-content>\n treatment, were randomised to receive celecoxib 100\u2010200 mg b.d., ibuprofen 600\u2010800 mg t.d.s. or naproxen 375\u2010500 mg b.d. plus esomeprazole, and low\u2010dose aspirin or corticosteroids if already prescribed. Clinically significant\n GI<\/jats:styled-content>\n events (\n CSGIE<\/jats:styled-content>\n \u2014bleeding, obstruction, perforation events from stomach downwards or symptomatic ulcers) and iron deficiency anaemia (\n IDA<\/jats:styled-content>\n ) were adjudicated blindly.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Mean treatment and follow\u2010up durations were 20.3 and 34.1 months. While on treatment or 30 days after,\n CSGIE<\/jats:styled-content>\n occurred in 0.34%, 0.74% and 0.66% taking celecoxib, ibuprofen and naproxen. Hazard ratios (\n HR<\/jats:styled-content>\n ) were 0.43 (95%\n CI<\/jats:styled-content>\n 0.27\u20100.68,\n P<\/jats:italic>\n = 0.0003) celecoxib vs ibuprofen and 0.51 (0.32\u20100.81,\n P<\/jats:italic>\n = 0.004) vs naproxen. There was also less\n IDA<\/jats:styled-content>\n on celecoxib:\n HR<\/jats:styled-content>\n 0.43 (0.27\u20100.68,\n P<\/jats:italic>\n = 0.0003) vs ibuprofen; 0.40 (0.25\u20100.62,\n P<\/jats:italic>\n < 0.0001) vs naproxen. Even taken with low\u2010dose aspirin, fewer\n CSGIE<\/jats:styled-content>\n occurred on celecoxib than ibuprofen (\n HR<\/jats:styled-content>\n 0.52 [0.29\u20100.94],\n P<\/jats:italic>\n = 0.03), and less\n IDA<\/jats:styled-content>\n vs naproxen (0.42 [0.23\u20100.77,\n P<\/jats:italic>\n = 0.005]). Corticosteroid use increased total\n GI<\/jats:styled-content>\n events and\n CSGIE<\/jats:styled-content>\n .\n H. pylori<\/jats:italic>\n serological status had no influence.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Arthritis patients taking\n NSAID<\/jats:styled-content>\n s plus esomeprazole have infrequent clinically significant gastrointestinal events. Co\u2010prescribed with esomeprazole, celecoxib has better overall\n GI<\/jats:styled-content>\n safety than ibuprofen or naproxen at these doses, despite treatment with low\u2010dose aspirin or corticosteroids.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/apt.14610","type":"journal-article","created":{"date-parts":[[2018,4,18]],"date-time":"2018-04-18T01:01:30Z","timestamp":1524013290000},"page":"1453-1463","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Randomised clinical trial: gastrointestinal events in arthritis patients treated with celecoxib, ibuprofen or naproxen in the\n PRECISION<\/scp>\n trial"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9870-832X","authenticated-orcid":false,"given":"N. D.","family":"Yeomans","sequence":"first","affiliation":[{"name":"Department of Medicine Austin Hospital University of Melbourne Melbourne Victoria Australia"},{"name":"Western Sydney University Campbelltown NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6908-8317","authenticated-orcid":false,"given":"D. Y.","family":"Graham","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Veterans Affairs Medical Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. E.","family":"Husni","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. H.","family":"Solomon","sequence":"additional","affiliation":[{"name":"Harvard Medical School Brigham and Women's Hospital Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Stevens","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Vargo","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Q.","family":"Wang","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. M.","family":"Wisniewski","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. 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F.","family":"L\u00fcscher","sequence":"additional","affiliation":[{"name":"Cardiology University Heart Center University Hospital Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Bao","sequence":"additional","affiliation":[{"name":"Pfizer New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Walker","sequence":"additional","affiliation":[{"name":"Pfizer Ltd Tadworth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. 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