Friday, 15 Dec 2017

You are here

PRECISION Subanalyses Question Aspirin Use

The PRECISION trial reported last year that celecoxib appears to be safer than the NSAIDs naproxen or ibuprofen in treating osteoarthritis (OA) and rheumatoid arthritis patients who are at increased cardiovascular risk. New data suggests that adding aspirin may nullify this advantage according to a study presented at the 2017 American Heart Association  (AHA) meeting and reported by Medscape.

A subanalysis of the 24,000 patients from the PRECISION trial was conducted to look at those who also took aspirin.

For those not taking aspirin, naproxen or ibuprofen had significantly greater risk of major adverse CV events (MACE), non-CV death, gastrointestinal (GI) events, and renal events than those receiving celecoxib.

The ibuprofen group also had significantly greater risk for MACE alone, for GI events, and for renal events vs the study-drug group; while the naproxen group had significantly greater risk for just GI and renal events.

The subanalyses shows that for those who take aspirin, the risk for the composite end point and for renal events was significantly greater only for the ibuprofen group; the risk for GI events was still greater for both groups vs those receiving celecoxib; and there were no longer any significant between-group differences in risk for MACE alone.

The presenting authors suggest that "you shouldn't take aspirin if you dont need aspirin".

 

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Physician Visit Times Vary Worldwide

A metanalysis published in BMJ Open shows that for half of the world’s population, primary care doctor visits last less than five minutes and that the range is from 48 seconds in Bangladesh to 22.5 minutes in Sweden (US PCP visit averages at 20 minutes).

Surgical Decompression Ineffective for Subacromial Shoulder Pain

Lancet reports that a common surgical intervention, arthroscopic sub-acromial decompression is ineffective compared to arthroscopy or no surgery at all.

ACR 2017 - Day 1 Highlights

Curtis and colleagues presented a plenary session that analyzed the duration of drug holidays and the risk of subsequent fractures (FX) in women starting bisphosphonates (BP). They looked at 156,236 women taking BP for 3 years (median 2.1 yrs.) and then discontinuing BP.  20% stopped BP for > 6 mos. and 12.7% restarted BP and 11% died. For those off BP for >2 yrs. there was a 40% increased risk of Hip Fx.

The Greatest Rheumatologist - Part I

Who is the greatest rheumatologist? What makes for a great rheum? Is it clinical acumen, scientific achievement, educational prowess or years of unrivaled service or mentoring? Rheumatologists are quite opinionated on this subject and very nostalgic about their mentors and leaders. When I’ve posed this question in small groups, it’s plain to see how moved they become when discussing mentors or peers who influenced them. Thus, I posed this question to many of our leaders and mentors: who do you think of as the greatest rheumatologist?

Top 16 Drugs in Rheumatology 2016

Using data compiled from annual reports, SEC filings, press releases, company websites, recently released sales figures show that in 2016, 11 of the top 16 rheumatology drugs demonstrated blockbuster sales (>$1 billion per annum).  Highlights from this report include: