Celecoxib Versus Naproxen for Prevention of Recurrent Ulcer Bleeding in Arthritis Patients

Launched by CHINESE UNIVERSITY OF HONG KONG · Sep 8, 2005

Keywords

ClinConnect Summary

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly consumed drugs worldwide for the relief of pain and arthritis. However, the use of NSAIDs increases the risk of ulcer bleeding by 4-fold. Current evidence indicates that combination of conventional NSAIDs and a proton pump inhibitor (PPI) reduces the risk of ulcer complications. The alternative strategy is to replace conventional, non-selective NSAIDs with NSAIDs selective for cyclooxygenase-2 (COX-2 inhibitors). Recently, there are concerns about the cardiovascular safety of COX-2 inhibitors and conventional NSAIDs. Becaus...

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Eligibility criteria

• Inclusion Criteria:
• • 1. age \>18,
• • 2. a history of endoscopically proven gastroduodenal ulcer bleeding,
• • 3. H. pylori negative
• • 4. a history of cardiothrombotic disease requiring ASA, and
• • 5. anticipated regular use of NSAIDs for the duration of trial
• Exclusion Criteria:
• • 1. concomitant use of anticoagulants;
• • 2. a history of gastric or duodenal surgery other than a patch repair;
• • 3. the presence of erosive esophagitis,
• • 4. gastric outlet obstruction,
• • 5. renal failure (defined by a serum creatinine level of more than 200 umol/L),
• • 6. pregnancy,
• • 7. terminal illness, or
• • 8. cancer