THURSDAY, June 17 (HealthDay News) -- Patients who take the
painkiller celecoxib for arthritis pain and inflammation are less likely
to suffer gastrointestinal damage than those who take diclofenac plus
omeprazole, a new study finds.
Celecoxib (Celebrex) is a cox-2 selective non-steroidal
anti-inflammatory drug (NSAID), diclofenac (Voltaren) is a non-selective
NSAID and omeprazole (Prilosec) is a proton pump inhibitor (PPI).
The study included 4,484 patients in 32 countries or territories who
were randomly selected to receive either 200 milligrams (mg) of celecoxib
twice a day (2,238 patients) or 75 mg of diclofenac slow-release plus 20
mg of omeprazole (2,246 patients) once a day.
Patients taking diclofenac plus omeprazole were more than four times
more likely to suffer upper or lower gastrointestinal damage than
celecoxib patients -- 3.8 percent versus 0.9 percent, respectively.
The findings, which were released online June 17 in advance of
publication in a future print issue of The Lancet, should prompt a
review of approaches used to reduce the risk of NSAID treatment, said the
authors of the CONDOR study.
"Since guidelines recommend that selection of NSAID therapy be driven
by consideration of both cardiovascular and gastrointestinal effects of
treatment, CONDOR has provided new data relevant to patients requiring
anti-inflammatory therapy who are at increased gastrointestinal but not
increased cardiovascular risk. In this population, the gastrointestinal
outcomes of a cox-2 selective NSAID were quite different to those of a
non-selective NSAID plus a PPI," Francis Chan of Prince of Wales Hospital,
Hong Kong Special Administrative Region, China, and Jay Goldstein of the
University of Illinois at Chicago, and colleagues wrote.
"Further understanding of the cardiovascular outcomes of these two
strategies requires the results of ongoing trials that have been designed
directly to address that important clinical question. The findings of the
CONDOR trial should encourage guideline committees to review their
treatment recommendations for arthritis patients," the researchers
concluded.
More information
The U.S. National Institute of Arthritis and Musculoskeletal and Skin
Diseases has more about arthritis.
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