For osteoarthritis or rheumatoid arthritis patients at high risk for cardiovascular disease (CVD), celecoxib, ibuprofen and naproxen carry a similar CVD risk, according to newly released results from the PRECISION trial.

PRECISION (full title: Prospective Randomized Evaluation of Celecoxib Integrated Safety vs. Ibuprofen Or Naproxen) was a long-term non-inferiority trial of 24,081 patients designed to assess the cardiovascular safety of celecoxib vs. prescription strength doses of ibuprofen and naproxen. 

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Results showed that the primary endpoint of CV death, non-fatal myocardial infarction (MI) or non-fatal stroke occurred in 2.3% of celecoxib (100–200mg twice daily) treated individuals compared to 2.5% of the naproxen (375–500mg twice daily) and 2.7% of ibuprofen (600–800mg three times a day) treated individuals. Additionally, the celecoxib group had less serious gastrointestinal events (1.1%) compared to the naproxen (1.5%) and ibuprofen (1.6%) group. 

“The study demonstrated that patients treated with prescription doses of celecoxib, ibuprofen or naproxen had similar rates of cardiovascular events and dispels the long held perception of excess cardiovascular risk associated with long term use of Celebrex,” said Ian Read, chairman and CEO of Pfizer Inc.

The trial was funded by Pfizer but directed independently by the Cleveland Clinic and governed by an executive committee comprised of cardiology, gastroenterology, and rheumatology specialists.

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