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Your Healthy Family: Study Determines Risk of Prescription Anti-inflammatory Drugs

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There’s new information for more than 50 million Americans who suffer from arthritis pain. 

For a decade, researchers have been concerned about how the popular arthritis drug celecoxib, also known as Celebrex, would impact the heart when compared to commonly prescribed drugs ibuprofen and naproxen. 

The study, known as the PRECISION trial, was published Sunday in the New England Journal of Medicine.

“The answer is now in and there was no increase in risk,” said Steven Nissen, M.D., Chairman of Cardiovascular Medicine at Cleveland Clinic and lead author of the PRECISION trial. “In fact, the actual number of cardiovascular events that occurred was smaller with celecoxib, or Celebrex, than with ibuprofen or naproxen.”

Study results

Researchers treated more than 24,000 people with osteoarthritis and rheumatoid arthritis who were at high risk for heart disease.

Participants were split into three groups and received daily prescription doses of either celecoxib, ibuprofen or naproxen. They were treated for an average of 20 months and followed for about three years.  

The primary results show that celecoxib did not increase the risk of heart complications. 

Researchers also looked into other known complications from these drugs – stomach ulcers, kidney problems and overall risk of dying. 

Secondary results show that celecoxib had generally lower risk of these complications when compared to ibuprofen and naproxen.

Dr. Nissen said the results were surprising and even more so when it came to naproxen.  

“Many guidelines and commentators over the years have recommended to heart patients that they take naproxen, it was believed to be the safest of the drugs and we didn’t find that,” said Dr. Nissen. “It wasn’t the safest of the drugs.”

Prescription strength drugs; used long-term

It’s important to note that the medication doses in the study were prescription strength and that study participants used the drugs long-term.

Dr. Nissen said Americans should not be excessively fearful of taking the occasional over-the-counter ibuprofen or naproxen for aches and pains as long as they are taking the recommended dose. 

“It is sobering and it does require people to understand that they need to stay within the dosing guidelines for those over the counter doses,” said Dr. Nissen.

Study co-author, Elaine Husni, M.D., Vice-Chair of Rheumatology at Cleveland Clinic, said the results give patients more options and will help doctors fine-tune treatment plans. 

“We’re able to make more individualized choices and more informed choices with our patients that need chronic NSAID treatment,” said Dr. Husni.

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