Randomized trial of switching from prescribed non-selective non-steroidal anti-inflammatory drugs to prescribed celecoxib: the Standard care vs. Celecoxib Outcome Trial (SCOT)

BackgroundSelective cyclooxygenase-2 inhibitors and conventional non-selective non-steroidal anti-inflammatory drugs (nsNSAIDs) have been associated with adverse cardiovascular (CV) effects. We compared the CV safety of switching to celecoxib vs. continuing nsNSAID therapy in a European setting.MethodPatients aged 60 years and over with osteoarthritis or rheumatoid arthritis, free from established CV disease and taking chronic prescribed nsNSAIDs, were randomized to switch to celecoxib or to continue their previous nsNSAID. The primary endpoint was hospitalization for non-fatal myocardial infarction or other biomarker positive acute coronary syndrome, non-fatal stroke or CV death analysed using a Cox model with a pre-specified non-inferiority limit of 1.4 for the hazard ratio (HR).ResultsIn total, 7297 participants were randomized. During a median 3-year follow-up, fewer subjects than expected developed an on-treatment (OT) primary CV event and the rate was similar for celecoxib, 0.95 per 100 patient-years, and nsNSAIDs, 0.86 per 100 patient-years (HR =  1.12, 95% confidence interval, 0.81–1.55;P =  0.50). Comparable intention-to-treat (ITT) rates were 1.14 per 100 patient-years with celecoxib and 1.10 per 100 patient-years with nsNSAIDs (HR = 1.04; 95% confidence interval, 0.81–1.33;P = 0.75). Pre-specified non-inferiority was achieved in the ITT analysis. The upper bound of the 95% confidence limit for the absolute incre...
Source: European Heart Journal - Category: Cardiology Source Type: research

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In this study, we investigated the link between AF and senescence markers through the assessment of protein expression in the tissue lysates of human appendages from patients in AF, including paroxysmal (PAF) or permanent AF (PmAF), and in sinus rhythm (SR). The major findings of the study indicated that the progression of AF is strongly related to the human atrial senescence burden as determined by p53 and p16 expression. The stepwise increase of senescence (p53, p16), prothrombotic (TF), and proremodeling (MMP-9) markers observed in the right atrial appendages of patients in SR, PAF, and PmAF points toward multiple inter...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Conclusion: Our meta-analysis results revealed higher cardiovascular risk in OA patients. This highlights the importance of cardiovascular risk factor management in OA.
Source: Joint Bone Spine - Category: Orthopaedics Source Type: research
Fight Aging! provides a weekly digest of news and commentary for thousands of subscribers interested in the latest longevity science: progress towards the medical control of aging in order to prevent age-related frailty, suffering, and disease, as well as improvements in the present understanding of what works and what doesn't work when it comes to extending healthy life. Expect to see summaries of recent advances in medical research, news from the scientific community, advocacy and fundraising initiatives to help speed work on the repair and reversal of aging, links to online resources, and much more. This content is...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
This study indicates that frailty and other age-related diseases could be prevented and significantly reduced in older adults. Getting our heart risk factors under control could lead to much healthier old ages. Unfortunately, the current obesity epidemic is moving the older population in the wrong direction, however our study underlines how even small reductions in risk are worthwhile." The study analysed data from more than 421,000 people aged 60-69 in both GP medical records and in the UK Biobank research study. Participants were followed up over ten years. The researchers analysed six factors that could impa...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
In conclusion, the present study demonstrated that TIGIT is a prominent negative immune regulator involved in immunosenescence. This novel finding is highly significant, as targeting TIGIT might be an effective strategy to improve the immune response and decrease age-related comorbidities. Delivery of Extracellular Vesicles as a Potential Basis for Therapies https://www.fightaging.org/archives/2018/01/delivery-of-extracellular-vesicles-as-a-potential-basis-for-therapies/ Here I'll point out a readable open access review paper on the potential use of extracellular vesicles as a basis for therapy: harveste...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Big Pharma is at it again… Creating and selling a drug that causes thousands of heart attacks and strokes each year. In 2015, the FDA asked drug makers to strengthen their warning labels. Since then, most have listed their dangerous side effects on the bottle. But one manufacturer thought they didn’t have to warn people about their dangerous drug. They marketed their product as a “unique” breakthrough. They even published studies promising it was “safe for long-term use.” 1 The drug is a 7-year-old arthritis drug called Actemra. It’s made by the Swiss pharmaceutical company Roche....
Source: Al Sears, MD Natural Remedies - Category: Complementary Medicine Authors: Tags: Anti-Aging Source Type: news
Ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen are and have been the go-to “benign” pain medication for doctors and patients alike. Why? They aren’t addictive, and it’s not easy to overdose. Serious side effects like gastrointestinal ulcers and bleeding seemed to be limited to high doses taken for longer periods or time, or to people with significant medical problems. Even before the era of the opioid epidemic, it was raining NSAIDs, across the country. In 2004, the manufacturer of the NSAID Vioxx pulled it from the market because the drug was associated with serious...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Back Pain Drugs and Supplements Headache Health Heart Health Injuries Pain Management Source Type: blogs
In this study we demonstrate the use of clustered regularly interspaced short palindromic repeats (CRISPR)-based epigenome editing to alter cell response to inflammatory environments by repressing inflammatory cytokine cell receptors, specifically TNFR1 and IL1R1. This has applications for many inflammatory-driven diseases. It could be applied for arthritis or to therapeutic cells that are being delivered to inflammatory environments that need to be protected from inflammation." In chronic back pain, for example, slipped or herniated discs are a result of damaged tissue when inflammation causes cells to create ...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
This study only included people with rheumatoid arthritis or osteoarthritis. The results might be different if people with other conditions had been included. Other medical problems. The risks and benefits of celecoxib in people with other medical problems (such as significant kidney disease) are uncertain because this study excluded them. Other medical treatments. All patients in this study took a medication to protect the stomach; outside of studies, that’s not always the case. While these issues are valid, I think this study does provide a significant measure of reassurance regarding the cardiovascular risks of c...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Arthritis Drugs and Supplements Health Heart Health Pain Management Source Type: blogs
Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used medications for osteoarthritis, rheumatoid arthritis, and myalgias (Table 1). In 2005, the United States Food and Drug Administration (FDA) placed a black box warning in the prescribing information of NSAIDs for the risk of myocardial infarction (MI) and stroke associated with their use.1 Last year, the FDA met to discuss new literature on NSAID cardiovascular (CV) risk to determine how it would affect prescription labeling.2 There were several observational studies and meta-analyses reviewed.
Source: The Journal for Nurse Practitioners - Category: Nursing Authors: Tags: Prescription Pad Source Type: research
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