| Study, Year Time Period Covered | Number of Studies (Number Randomized to Celecoxib) | Includes Trials of Colorectal Cancer or Alzheimer’s Prevention* | Risk of Cardiovascular Events | Quality |
|---|---|---|---|---|
| White, 2003112 Search dates not reported | 15 (18,942) | No | Antiplatelet Trialists’ Collaboration composite CV events (cardiovascular, hemorrhagic, and unknown deaths; nonfatal MI; or nonfatal stroke) All patients Celecoxib vs. placebo: RR 0.85 (95% CI 0.23 to 3.15) Celecoxib vs. NSAIDs: RR 1.06 (95% CI 0.70 to 1.61) Celecoxib vs. naproxen: RR 0.85 (95% CI 0.29 to 2.46) Aspirin nonusers Celecoxib vs. placebo: RR 0.60 (95% CI 0.11 to 3.29) Celecoxib vs. NSAIDs: RR 0.86 (95% CI 0.48 to 1.56) Celecoxib vs. naproxen: RR 0.82 (95% CI 0.18 to 2.46) | Poor |
| Moore, 200551 Trials completed by December 2003 | 31 (22,192) | No | Myocardial infarction Celecoxib vs. placebo: RR not reported (10 events) Celecoxib 200–400 mg vs. NSAID to maximum daily dose: RR 1.9 (95% CI, 0.87 to 4.1) Celecoxib any dose vs. NSAID to maximum daily dose: RR 1.6 (95% CI 0.93 to 2.6) | Fair |
| Caldwell, 2006111 Searches through April 2005 | 6 (6,859) | Yes | Celecoxib vs. placebo Myocardial infarction: RR 2.3 (95% CI 1.0 to 5.1) Cerebrovascular event: RR 1.0 (95% CI 0.51 to 1.8) Cardiovascular death: RR 1.1 (95% CI 0.38 to 3.0) Composite cardiovascular events: RR 1.38 (95% CI 0.91 to 2.1) Celecoxib vs. placebo, diclofenac, ibuprofen, or paracetamol Myocardial infarction: RR 1.9 (95% CI 1.2 to 3.1) Cerebrovascular event: RR 0.73 (95% CI 0.42 to 1.3) Cardiovascular death: RR 1.0 (95% CI 0.52 to 2.0) Composite cardiovascular events: RR 1.2 (95% CI 0.92 to 1.6) | Fair |
| White, 2007113 Trials completed by October 2004 | 41 (23,030) | No | Celecoxib 200–800 mg vs. placebo Antiplatelet Trialists’ Collaboration composite CV events: RR 1.1 (95% CI 0.47 to 2.7) CV deaths: RR 1.3 (95% CI 0.33 to 4.8) Nonfatal MI: RR 1.6 (95% CI 0.21 to 12) Nonfatal stroke: RR 0.80 (95% CI 0.19 to 3.3) Celecoxib 200–800 mg vs. nonselective NSAIDs Antiplatelet Trialists’ Collaboration composite CV events: RR 0.90 (95% CI 0.60 to 1.3) CV deaths: RR 0.57 (95% CI 0.28 to 1.1) Nonfatal MI: RR 1.8 (95% CI 0.93 to 3.4) Nonfatal stroke: RR 0.51 (95% CI 0.23 to 1.1) | Poor |
| Solomon, 2008114 Search dates not reported | 6 (3664) | Yes | Cardiovascular death, MI, stroke, heart failure, or thromboembolism Celecoxib any dose vs. placebo: HR 1.6 (95% CI 1.1 to 2.3) Celecoxib 400 mg qd vs. placebo: HR 1.1 (95% CI 0.6 to 2.0) Celecoxib 200 mg bid vs. placebo: HR 1.8 (95% CI 1.1 to 3.1) Celecoxib 400 mg bid vs. placebo: HR 3.1 (95% CI 1.6 to 6.1) | Fair |
bid = twice daily; CI = confidence interval; CV = cardiovascular; HR = hazard ratio; MI = myocardial infarction; NSAID = nonsteroidal anti-inflammatory drug; qd = once daily; RR = relative risk
Colon polyp prevention trials: PreSAP, APC; Alzheimer’s prevention: ADAPT
From: Results
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