Celecoxib vs. Naproxen for Reducing GI Bleeding Recurrence in High-Risk Patients on Aspirin

Concomitant use of nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin magnifies the elevated risk for upper gastrointestinal (GI) bleeding with use of either, yet treatment of serious cardiovascular and inflammatory comorbidities often indicate both.

To evaluate whether celecoxib or naproxen is more effective in preventing recurrent GI bleeding in this setting, investigators in Hong Kong identified 514 patients with arthritis and a cardiothrombotic disease who had upper GI bleeding while taking both an NSAID and aspirin and randomized them to receive celecoxib (100 mg) or naproxen (500 mg) twice daily for 18 months. Both groups also took aspirin (80 mg daily) after confirmation of ulcer healing and exclusion of Helicobacter pylori inf…