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Coxibs are associated with a lower risk for gastrointestinal (GI) adverse events compared with nonselective nonsteroidal anti-inflammatory drugs (nsNSAIDs). It has been suggested that concomitant use of aspirin mitigates this benefit.
In a meta-analysis of data from 84,150 patients participating in 11 trials, investigators compared risks for complicated GI events (bleeding, obstruction, perforation) and clinical events (complicated events plus symptomatic ulcers) between coxib users and nsNSAID users across subgroups of low-dose aspirin users and nonusers.
Results were as follows:
Risk for complications was lower with coxibs versus nsNSAIDs (relative risk, 0.54), but concomitant aspirin use eliminated this risk reduction (RR, 0.90); in aspirin…