The trial that cleared celecoxib did not dose the drugs comparably
A head-to-head trial in 24,081 arthritis patients found celecoxib no worse than ibuprofen or naproxen for heart attack and stroke. Mean daily doses ran 209 mg against 2,045 mg.
What the study found
The trial clearing celecoxib gave it 209 mg against ibuprofen's 2,045
A randomised head-to-head trial in 24,081 arthritis patients found celecoxib no worse than ibuprofen or naproxen for heart attack, stroke and cardiovascular death. Mean daily doses ran 209 mg of celecoxib against 852 mg of naproxen and 2,045 mg of ibuprofen.
The caveat · Seven in ten stopped the study drug
Nearly seven in ten participants stopped taking the study drug and more than a quarter stopped follow-up altogether, which blunts every comparison the trial makes. It was funded by celecoxib's manufacturer. A non-inferiority design can show one drug is not clearly worse than another; it cannot show that any of them is safe. Everyone enrolled had arthritis and raised cardiovascular risk.
What we don't know
Whether celecoxib is as heart-safe as ibuprofen and naproxen is unsettled. Prescribing data rank it riskier; the one large trial found it no worse but dosed the drugs unequally, and no study has compared them at matched doses.