Risks of NSAID Toxicity May Differ Between Medications

By Spondylitis Association of America

Monday, November 20, 2017

Chances are, if you are living with spondyloarthritis, you have taken Non-Steroidal Anti-Inflammatory Drugs (NSAIDs,) as they are the most widely used class of medications for spondyloarthritis symptom relief. You are also likely aware that all NSAIDs carry some risk of major toxicity. A recent study now suggests that some NSAIDs carry higher risks for older adults who take NSAIDs regularly.   

The PRECISION trial, carried out in 2016, sought to differentiate between toxicity severities of three NSAID medications. A pool of over 24,000 older arthritis patients, with moderate – to – severe cardiovascular risks, were given naproxen, ibuprofen or celecoxib and asked to remain on that medication for a duration of about 20 months. The patients were then examined for major NSAID toxicities, such as cardiovascular, gastrointestinal, and renal events in order to determine whether or not the toxic event was triggered by the medication. Earlier in 2017 a secondary analysis of the PRECISION trail was conducted.

Study Findings

While the original analysis had discovered a small favorability towards celecoxib, the differences weren’t found to be statistically significant. The more recent, secondary analysis, on the other hand, found that the risk for a major toxic event was 19% higher with naproxen and 41% higher with ibuprofen, compared to celecoxib.

“Daily use of these drugs confers a much higher risk than taking them once in a while,” said the study’s first author, Dr. Daniel Solomon. He concluded in saying, “For people who take them chronically at a moderate dosage, they should consider the use of celecoxib over the other agents.”

The next step in the process is to examine the possibility of predicting the development of NSAID-related problems in individuals, which would allow for a safer distribution of these medications.

The PRECISION trial was funded by Pfizer, which sells celecoxib as Celebrex. 


Sources Used and Further Reading:

Celecoxib may be safest choice for older, chronic NSAID users

Celebrex arthritis drug safety surprises heart experts


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