PMID- 21561397
OWN - NLM
STAT- MEDLINE
DCOM- 20111101
LR  - 20151119
IS  - 1473-4877 (Electronic)
IS  - 0300-7995 (Linking)
VI  - 27
IP  - 7
DP  - 2011 Jul
TI  - Gastrointestinal tolerability of NSAIDs in elderly patients: a pooled analysis of 
      21 randomized clinical trials with celecoxib and nonselective NSAIDs.
PG  - 1359-66
LID - 10.1185/03007995.2011.581274 [doi]
AB  - BACKGROUND: Gastrointestinal (GI) tolerability is an important treatment 
      consideration for physicians when choosing a nonselective nonsteroidal 
      anti-inflammatory drug (NSAID) for their elderly arthritis patients. The 
      objective of this study was to compare the GI tolerability of the 
      cyclooxygenase-2 selective NSAID celecoxib and nonselective NSAIDs in elderly 
      patients with arthritis aged 65 years or older. METHODS: This was a 
      retrospective, pooled analysis of patients aged 65 years or older with 
      osteoarthritis (OA), rheumatoid arthritis (RA), or ankylosing spondylitis (AS) 
      from randomized, parallel-group trials. Selected trials had a duration of >/=2 
      weeks and at least one celecoxib 200-400 mg/day and one nonselective NSAID 
      (naproxen, ibuprofen, or diclofenac) arm. Patient-level data from the safety 
      populations of the trials were pooled. Analysis included the combined incidence 
      of the GI intolerability adverse events (AEs) (abdominal pain, constipation, 
      diarrhea, dyspepsia, flatulence, nausea) and incidence and time to trial 
      discontinuation due to these intolerability AEs. RESULTS: A total of 21 trials 
      were selected involving 9461 elderly patients (mean age 71.9 years). Of these, 
      5872 received celecoxib, 1104 naproxen, 151 ibuprofen, and 2334 diclofenac. The 
      combined incidence of GI intolerability AEs were reported by significantly fewer 
      patients treated with celecoxib (16.7%) than naproxen (29.4%; p < 0.0001), 
      ibuprofen (26.5%; p = 0.0016), or diclofenac (21.0%; p < 0.0001). The 
      discontinuation rate due to GI intolerability AEs was significantly lower for 
      celecoxib (4.0%) versus naproxen (8.1%; p < 0.0001) and ibuprofen (7.3%; p < 
      0.05), but not diclofenac (4.2%; p = 0.75). CONCLUSIONS: Among elderly arthritis 
      patients, the incidence of GI intolerability AEs was lower with celecoxib than 
      with naproxen, ibuprofen, or diclofenac. Fewer elderly patients discontinued due 
      to GI intolerability AEs with celecoxib than with either naproxen or ibuprofen.
FAU - Mallen, Sharon R
AU  - Mallen SR
AD  - Medical Affairs, Pfizer Inc., New York, NY 10017, USA. sharon.mallen@pfizer.com
FAU - Essex, Margaret N
AU  - Essex MN
FAU - Zhang, Richard
AU  - Zhang R
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20110512
PL  - England
TA  - Curr Med Res Opin
JT  - Current medical research and opinion
JID - 0351014
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 0 (Pyrazoles)
RN  - 0 (Sulfonamides)
RN  - JCX84Q7J1L (Celecoxib)
SB  - IM
MH  - *Aged
MH  - Anti-Inflammatory Agents, Non-Steroidal/*adverse effects/therapeutic use
MH  - Celecoxib
MH  - Gastrointestinal Diseases/*chemically induced/*epidemiology
MH  - Gastrointestinal Tract/drug effects
MH  - Humans
MH  - Incidence
MH  - Pyrazoles/*adverse effects/therapeutic use
MH  - Randomized Controlled Trials as Topic/statistics & numerical data
MH  - Retrospective Studies
MH  - Substrate Specificity
MH  - Sulfonamides/*adverse effects/therapeutic use
EDAT- 2011/05/13 06:00
MHDA- 2011/11/02 06:00
CRDT- 2011/05/13 06:00
PHST- 2011/05/13 06:00 [entrez]
PHST- 2011/05/13 06:00 [pubmed]
PHST- 2011/11/02 06:00 [medline]
AID - 10.1185/03007995.2011.581274 [doi]
PST - ppublish
SO  - Curr Med Res Opin. 2011 Jul;27(7):1359-66. doi: 10.1185/03007995.2011.581274. 
      Epub 2011 May 12.