{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T12:42:51Z","timestamp":1791636171322,"version":"4.3.4"},"reference-count":56,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T00:00:00Z","timestamp":1640044800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation","doi-asserted-by":"crossref","award":["No.81830115"],"award-info":[{"award-number":["No.81830115"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100008460","name":"NCCIH","doi-asserted-by":"crossref","award":["AT001293 with sub-award No. 020468C"],"award-info":[{"award-number":["AT001293 with sub-award No. 020468C"]}],"id":[{"id":"10.13039\/100008460","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>To assess the cardiovascular safety of celecoxib compared to non-selective non-steroid anti-inflammatory drugs or placebo.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We included randomized controlled trials of oral celecoxib compared with a non-selective NSAID or placebo in rheumatoid arthritis and osteoarthritis patients. We conducted searches in EMBASE, Cochrane CENTRAL, MEDLINE, China National Knowledge Infrastructure, VIP, Wanfang, and Chinese Biomedical Literature Database. Study selection and data extraction were done by two authors independently. The risk of bias was assessed using Cochrane\u2019s risk-of-bias Tool for Randomized Trials. The effect size was presented as a risk ratio with their 95% confidence interval.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Until July 22<jats:sup>nd<\/jats:sup>, 2021, our search identified 6279 records from which, after exclusions, 21 trials were included in the meta-analysis. The overall pooled risk ratio for Antiplatelet Trialists Collaboration cardiovascular events for celecoxib compared with any non-selective non-steroid anti-inflammatory drugs was 0.89 (95% confidence interval: 0.80\u20131.00). The pooled risk ratio for all-cause mortality for celecoxib compared with non-selective non-steroid anti-inflammatory drugs was 0.81 (95% confidence interval: 0.66\u20130.98). The cardiovascular mortality rate of celecoxib was lower than non-selective non-steroid anti-inflammatory drugs (risk ratio: 0.75, 95% confidence interval: 0.57\u20130.99). There was no significant difference between celecoxib and non-selective non-steroid anti-inflammatory drugs or placebo in the risk of other cardiovascular events.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Celecoxib is relatively safe in rheumatoid arthritis and osteoarthritis patients, independent of dose or duration. But it remains uncertain whether this would remain the same in patients treated with aspirin and patients with established cardiovascular diseases.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0261239","type":"journal-article","created":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T18:41:41Z","timestamp":1640112101000},"page":"e0261239","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":36,"title":["Cardiovascular safety of celecoxib in rheumatoid arthritis and osteoarthritis patients: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2216-9195","authenticated-orcid":true,"given":"Bai-Ru","family":"Cheng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia-Qi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Wen","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin-Yang","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Hong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Jiao","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Qiao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang-Jiang","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing-Li","family":"Xing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4814-4284","authenticated-orcid":true,"given":"Jian-Ping","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,12,21]]},"reference":[{"issue":"9746","key":"pone.0261239.ref001","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1016\/S0140-6736(10)60826-4","article-title":"Rheumatoid Arthritis","volume":"376","author":"DL Scott","year":"2010","journal-title":"Lancet"},{"issue":"9991","key":"pone.0261239.ref002","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/S0140-6736(14)60802-3","article-title":"Osteoarthritis","volume":"386","author":"S Glyn-Jones","year":"2015","journal-title":"The Lancet"},{"issue":"3","key":"pone.0261239.ref003","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1097\/BOR.0b013e32835fd7f8","article-title":"Rheumatoid arthritis and cardiovascular disease: an update on treatment issues","volume":"25","author":"M Barbhaiya","year":"2013","journal-title":"Curr Opin Rheumatol"},{"issue":"4","key":"pone.0261239.ref004","first-page":"673","article-title":"Incidence and risk of fatal myocardial infarction and stroke events in rheumatoid arthritis patients. A systematic review of the literature","volume":"26","author":"L L\u00e9vy","year":"2008","journal-title":"Clinical and experimental rheumatology"},{"issue":"12","key":"pone.0261239.ref005","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1016\/j.autrev.2010.07.018","article-title":"The effect of pharmacological therapy on the cardiovascular system of patients with systemic rheumatic diseases","volume":"9","author":"F Atzeni","year":"2010","journal-title":"Autoimmun Rev"},{"issue":"9","key":"pone.0261239.ref006","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1177\/2047487315610663","article-title":"Association between osteoarthritis and cardiovascular disease: Systematic review and meta-analysis","volume":"23","author":"AJ Hall","year":"2016","journal-title":"Eur J Prev Cardiol"},{"issue":"9894","key":"pone.0261239.ref007","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1016\/S0140-6736(13)60900-9","article-title":"Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials","volume":"382","author":"Collaboration CatNTC","year":"2013","journal-title":"The Lancet"},{"issue":"18","key":"pone.0261239.ref008","doi-asserted-by":"crossref","first-page":"2457","DOI":"10.2165\/11208240-000000000-00000","article-title":"Celecoxib A Review of Its Use for Symptomatic Relief in the Treatment of Osteoarthritis, Rheumatoid Arthritis and Ankylosing Spondylitis","volume":"71","author":"PL McCormack","year":"2011","journal-title":"Drugs"},{"issue":"4","key":"pone.0261239.ref009","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1111\/j.1572-0241.2001.03740.x","article-title":"Reduced incidence of gastroduodenal ulcers with celecoxib, a novel cyclooxygenase-2 inhibitor, compared to naproxen in patients with arthritis","volume":"96","author":"JL Goldstein","year":"2001","journal-title":"Am J Gastroenterol"},{"issue":"966","key":"pone.0261239.ref010","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1136\/pgmj.2005.042234","article-title":"COX-2 inhibitors and the heart: are all coxibs the same?","volume":"82","author":"P. 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