Table 5Meta-analyses of serious cardiovascular events in trials of celecoxib

Study, Year
Time Period Covered
Number of Studies (Number Randomized to Celecoxib)Includes Trials of Colorectal Cancer or Alzheimer’s Prevention*Risk of Cardiovascular EventsQuality
White, 2003112
Search dates not reported
15 (18,942)NoAntiplatelet 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)NoMyocardial 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)YesCelecoxib 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)NoCelecoxib 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)YesCardiovascular 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

Cover of Analgesics for Osteoarthritis
Analgesics for Osteoarthritis: An Update of the 2006 Comparative Effectiveness Review [Internet].
Comparative Effectiveness Reviews, No. 38.
Chou R, McDonagh MS, Nakamoto E, et al.

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