Bad News for Naproxen in RA

"Cardiovascular disease in RA is more common than in OA, which we think is because of the underlying systemic inflammation," Solomon told MedPage Today. A surprising finding in a subgroup analysis of the PRECISION study was a doubling in the all-cause mortality among patients with rheumatoid arthritis (RA) associated with naproxen use compared with celecoxib treatment, researchers reported here at the annual meeting of the American College of Rheumatology. Among patients with RA, there were 15 deaths in the celecoxib group and 30 deaths in the naproxen arm (HR 0.47, 95% CI 0.25-0.88, P=0.02), reported co-investigator Daniel H. Solomon, MD, of Brigham and Women's Hospital and Harvard University in Boston, in a poster session. This was not the case with osteoarthritis (OA), in which the all-cause mortality rate was similar in the celecoxib, naproxen, and ibuprofen arms. Among the OA patients, the hazard ratio for celecoxib vs naproxen was 0.87 (95% CI 0.68-1.12, P=0.28), according to another investigator, M. Elaine Husni, MD, of the Cleveland Clinic. PRECISION was a double-blind study that enrolled 24,081 patients with OA or RA who were considered to be at cardiovascular (CV) risk, with 10% of the total having RA and the remainder having OA. http://www.medpagetoday.com/MeetingCoverage/ACR/61430?xid=nl_mpt_DHE_2016-11-15&eun=g721819d0r&pos=3