New data on safety of NSAIDs: concept of the «class-specific» high cardiovascular risk of selective COX-2 inhibitors got out of date


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Abstract

At the end of 2016, the results of the PRECISION study have been published. In this study, 24 081 patients with high cardiovascular risk were receiving celecoxib 200-400 mg/day, naproxen 750-1000 mg/day, or ibuprofen 1800-2400 mg/day for more than 1.5 years (20.3±16.0 months). According to the data received, the frequency of vascular catastrophes (deaths, nonfatal myocardial infarction, and stroke) on the background of use of celecoxib did not exceed the frequency of similar complications when taking control drugs. Furthermore, celecoxib showed a statistically significant benefit in reducing the risk of serious gastrointestinal complications. The new data disproves the concept of «high cardiovascular risk» inherent in all coxibes and confirms the provisions of the national guidelines for the rational use of non-steroidal anti-inflammatory drugs (NSAIDs) published in 2015. This review presents the latest data on the risk of complications with the use of various NSAIDs, including a brief description of the plan and the results of the PRECISION study.

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About the authors

Andrey Ye. Karateev

V.A. Nasonova Research institute of rheumatology

MD, head of the Laboratory of gastrointestinal problems in rheumatic diseases

Yevgeny L. Nasonov

V.A. Nasonova Research institute of rheumatology

academician of RAS, MD, professor, head of the Department of vascular pathology of rheumatic diseases

Diana S. Novikova

V.A. Nasonova Research institute of rheumatology

PhD, senior researcher of the Laboratory of ultrasound diagnostics

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