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The association between nonsteroidal anti-inflammatory drugs (NSAIDs) and upper gastrointestinal (GI) bleeding and ulceration is well documented. Such adverse events can be reduced by use of a cyclooxygenase (COX)-2 selective NSAID or a proton-pump inhibitor (PPI) with a nonselective NSAID. However, prospective trials that evaluate these strategies to prevent NSAID-related events throughout the GI tract are lacking.
To address this issue, investigators conducted an industry-sponsored trial (CONDOR), involving 4484 patients with osteoarthritis or rheumatoid arthritis from 196 centers in 32 countries. Patients were randomized to receive celecoxib (Celebrex; 200 mg twice daily) or diclofenac (75 mg twice daily) plus omeprazole (20 mg once daily…