{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T11:37:31Z","timestamp":1791891451268,"version":"4.3.4"},"reference-count":18,"publisher":"BMJ","issue":"7365","license":[{"start":{"date-parts":[[2002,9,21]],"date-time":"2002-09-21T00:00:00Z","timestamp":1032566400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"accepted":{"date-parts":[[2002,3,27]]},"published-print":{"date-parts":[[2002,9,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Objective:<\/jats:bold>\n                    To determine the efficacy, gastrointestinal safety, and tolerability of celecoxib (a cyclo-oxygenase 2 (COX 2) inhibitor) used in the treatment of osteoarthritis and rheumatoid arthritis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Design:<\/jats:bold>\n                    Systematic review of randomised trials that compared at least 12 weeks' celecoxib treatment with another non-steroidal anti-inflammatory drug (NSAID) or placebo and reported efficacy, tolerability, or safety. Trials identified from manufacturer and by searching electronic databases and evaluated according to predefined inclusion and quality criteria. Data combined through meta-analysis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Participants:<\/jats:bold>\n                    15 187 patients with osteoarthritis or rheumatoid arthritis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Main outcome measures:<\/jats:bold>\n                    Efficacy: Western Ontario and McMaster universities osteoarthritis index; American College of Rheumatology responder index and joint scores for rheumatoid arthritis. Tolerability: withdrawal rates for adverse effects. Gastrointestinal safety: incidence of ulcers, bleeds, perforations, and obstructions.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Nine randomised controlled trials were included. Celecoxib and NSAIDS were equally effective for all efficacy outcomes. Compared with those taking other NSAIDs, in patients taking celecoxib the rate of withdrawals due to adverse gastrointestinal events was 46% lower (95% confidence interval 29% to 58%; NNT 35 at three months), the incidence of ulcers detectable by endoscopy was 71% lower (59% to 79%; NNT 6 at three months), and the incidence of symptoms of ulcers, perforations, bleeds, and obstructions was 39% lower (4% to 61%; NNT 208 at six months). Subgroup analysis of patients taking aspirin showed that the incidence of ulcers detected by endoscopy was reduced by 51% (14% to 72%) in those given celecoxib compared with other NSAIDs. The reduction was greater (73%, 52% to 84%) in those not taking aspirin.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Celecoxib is as effective as other NSAIDs for relief of symptoms of osteoarthritis and rheumatoid arthritis and has significantly improved gastrointestinal safety and tolerability.\n                  <\/jats:p>","DOI":"10.1136\/bmj.325.7365.619","type":"journal-article","created":{"date-parts":[[2002,9,19]],"date-time":"2002-09-19T18:43:45Z","timestamp":1032461025000},"page":"619","source":"Crossref","is-referenced-by-count":258,"title":["Efficacy, tolerability, and upper gastrointestinal safety of celecoxib for treatment of osteoarthritis and rheumatoid arthritis: systematic review of randomised controlled trials"],"prefix":"10.1136","volume":"325","author":[{"given":"Jonathan J","family":"Deeks","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesley A","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew D","family":"Bradley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2002,9,21]]},"reference":[{"key":"2025122123194881000_325.7365.619.1","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1136\/bmj.300.6720.278","article-title":"Non-steroidal anti-inflammatory drugs and peptic ulcers.","volume":"300","author":"Hawkey","year":"1990","journal-title":"BMJ"},{"key":"2025122123194881000_325.7365.619.2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.1997.d01-604.x"},{"key":"2025122123194881000_325.7365.619.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(99)00267-5"},{"key":"2025122123194881000_325.7365.619.4","unstructured":"British Medical Association, Royal Pharmaceutical Society of Great Britain .British national formulary. London: BMA, RPS,2000:447\u2013455 (No 39)."},{"key":"2025122123194881000_325.7365.619.5","doi-asserted-by":"crossref","unstructured":"Deeks JJ Altman DG Bradburn MJ .Statistical methods for examining heterogeneity and combining results from several studies in meta-analysis. In: Egger M Davey Smith G Altman DG eds.Systematic reviews in health care. London: BMJ Publishing, 2001:285\u2013312.","DOI":"10.1002\/9780470693926.ch15"},{"key":"2025122123194881000_325.7365.619.6","doi-asserted-by":"publisher","DOI":"10.4065\/74.11.1095"},{"key":"2025122123194881000_325.7365.619.7","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.20.1921"},{"key":"2025122123194881000_325.7365.619.8","unstructured":"Study 62 . Integrated clinical and statistical report for a multicenter, double blind, parallel group study comparing the incidence of gastroduodenal ulcer associated with SC-58635 200 mg with that of naproxen 500 mg BID taken for 12 weeks in patients with osteoarthritis or rheumatoid arthritis.Pharmacia: Data on file.1997."},{"key":"2025122123194881000_325.7365.619.9","unstructured":"Study 071 . Integrated clinical and statistical report for a multicenter, double blind, parallel group study comparing the incidence of gastroduodenal ulcer associated with SC-58635 200 mg BID with that of diclofenac 75 mg BID and ibuprofen 800 mg TID, taken for 12 weeks in patients with osteoarthritis or rheumatoid arthritis. Pharmacia: Data on file.1998."},{"key":"2025122123194881000_325.7365.619.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)02332-6"},{"key":"2025122123194881000_325.7365.619.11","doi-asserted-by":"publisher","DOI":"10.1001\/jama.284.10.1247"},{"key":"2025122123194881000_325.7365.619.12","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1002\/1529-0131(200004)13:2<112::AID-ANR5>3.0.CO;2-L","article-title":"Evaluation of health-related quality of life of rheumatoid arthritis patients treated with celecoxib.","volume":"13","author":"Zhao","year":"2000","journal-title":"Arthritis Care Res"},{"key":"2025122123194881000_325.7365.619.13","doi-asserted-by":"publisher","DOI":"10.1592\/phco.19.16.1269.30879"},{"key":"2025122123194881000_325.7365.619.14","unstructured":"Study 054 . Integrated clinical and statistical report for a double-blind placebo controlled, randomised comparison study of the efficacy and safety of SC-58635 50 mg, 100 mg and 200 mg BID and naproxen 500 mg BID in treating the signs and symptoms of osteoarthritis of the hip. Pharmacia: Data on file.1997."},{"issue":"suppl 6.3","key":"2025122123194881000_325.7365.619.15","first-page":"6","article-title":"Success-I in osteoarthritis (OA) trial: celecoxib has similar efficacy to the conventional NSAIDS [abstract].","volume":"28","author":"Singh","year":"2001","journal-title":"J Rheumatol"},{"key":"2025122123194881000_325.7365.619.16","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.323.7308.301"},{"key":"2025122123194881000_325.7365.619.17","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.324.7349.1287"},{"key":"2025122123194881000_325.7365.619.18","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200011233432103"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.325.7365.619","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.325.7365.619","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T07:19:55Z","timestamp":1766387995000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.325.7365.619"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002,9,21]]},"references-count":18,"journal-issue":{"issue":"7365","published-online":{"date-parts":[[2002,9,21]]},"published-print":{"date-parts":[[2002,9,21]]}},"alternative-id":["10.1136\/bmj.325.7365.619"],"URL":"https:\/\/doi.org\/10.1136\/bmj.325.7365.619","relation":{},"ISSN":["0959-8138","1468-5833"],"issn-type":[{"value":"0959-8138","type":"print"},{"value":"1468-5833","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002,9,21]]}}}