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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".