Last reviewed · How we verify

NCT00346216: PRECISION

Prospective Randomized Evaluation Of Celecoxib Integrated Safety Vs Ibuprofen Or Naproxen

Completed Phase 4 Results posted Last updated 3 March 2021
What this trial tests

Phase 4 trial testing celecoxib in Arthritis, Rheumatoid in 24,081 participants. Completed in 12 April 2016.

Timeline
4 October 2006
Primary endpoint
12 April 2016
12 April 2016

Quick facts

Lead sponsorPfizer's Upjohn has merged with Mylan to form Viatris Inc.
PhasePhase 4
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingtriple
Primary purposetreatment
Enrollment24,081
Start date4 October 2006
Primary completion12 April 2016
Estimated completion12 April 2016
Sites1066 locations across Hong Kong, Colombia, Costa Rica, Panama, Ukraine, Peru, Taiwan, Mexico

Drugs / interventions tested

Conditions studied

Sponsor

Pfizer's Upjohn has merged with Mylan to form Viatris Inc. — full company profile →

Who can join

18 and older, any sex, with Arthritis, Rheumatoid. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

The First Occurrence of Antiplatelet Trialists Collaboration (APTC) Composite Endpoint, Confirmed by the Clinical Events Committee (CEC). Primary · Intent to Treat (ITT) Population - 30 months; Modified ITT (MITT) Population - 42 months

APTC events are defined as a composite of any of the following events: Death due to CV causes (including cardiac, cerebrovascular, venous thromboembolic, haemorrhagic, other vascular, or unknown cause); Non-fatal MI; Non-fatal stroke (including intracranial hemorrhages, stroke of ischemic or unknown etiology).

ITT (N = 8072, 8040, 7969)
GroupValue95% CI
Celecoxib2.3
Ibuprofen2.7
Naproxen2.5
MITT (N = 8030, 7990, 7933)
GroupValue95% CI
Celecoxib1.7
Ibuprofen1.9
Naproxen1.8
The First Occurrence of a Major Adverse Cardiovascular Events (MACE) Secondary · ITT Population - 30 months; MITT Population - 42 months

MACE defined as the composite of CV death (including hemorrhagic death), non-fatal MI, non-fatal stroke, hospitalization for UA, revascularization or hospitalization for TIA

ITT (N = 8072, 8040, 7969)
GroupValue95% CI
Celecoxib4.2
Ibuprofen4.8
Naproxen4.3
MITT (N = 8030, 7990, 7933)
GroupValue95% CI
Celecoxib3.1
Ibuprofen3.6
Naproxen3.2
The First Occurrence of Clinically Significant Gastrointestinal Events (CSGIE) Secondary · ITT Population - 30 months; MITT Population - 42 months

CSGIE include: Gastroduodenal (GD) hemorrhage, Gastric outlet obstruction, Gastroduodenal, small bowel or large bowel perforation, Large bowel hemorrhage, Small bowel hemorrhage, Acute GI hemorrhage of unknown origin, including presumed small bowel hemorrhage, Symptomatic gastric or duodenal ulcer

ITT (N = 8072, 8040, 7969)
GroupValue95% CI
Celecoxib0.7
Ibuprofen0.9
Naproxen0.7
MITT (N = 8030, 7990, 7933)
GroupValue95% CI
Celecoxib0.3
Ibuprofen0.7
Naproxen0.7
Change From Baseline in Patient's Assessment of Arthritis Pain (VAS) Secondary · ITT and MITT Population - Baseline to 42 months

VAS question "How much pain do you have" was graded on a scale from 0 to 100 with 0 indicating "No pain" and 100 indicating "Worst possible pain".

Baseline (ITT) N= 8014, 8001, 7928
GroupValue95% CI
Celecoxib54.0± 23.53
Ibuprofen54.1± 23.58
Naproxen54.1± 24.04
Change-Baseline to Mon1 (ITT) N=7382, 7379, 7325
GroupValue95% CI
Celecoxib-8.2± 24.69
Ibuprofen-9.0± 25.69
Naproxen-9.9± 25.53
Change-Baseline to Mon2 (ITT) N=7180, 7090, 7149
GroupValue95% CI
Celecoxib-10.5± 26.39
Ibuprofen-10.6± 26.92
Naproxen-11.1± 26.83
Change-Baseline to Mon4 (ITT) N=6777, 6696, 6740
GroupValue95% CI
Celecoxib-11.4± 27.70
Ibuprofen-11.7± 28.10
Naproxen-12.3± 27.80
Change-Baseline to Mon8 (ITT) N=6230, 6137, 6159
GroupValue95% CI
Celecoxib-11.7± 28.92
Ibuprofen-12.1± 28.97
Naproxen-12.1± 28.83
Change-Baseline to Mon12 (ITT) N=5792, 5696, 5846
GroupValue95% CI
Celecoxib-11.0± 29.15
Ibuprofen-11.6± 29.29
Naproxen-11.9± 29.30
Change-Baseline to Mon18 (ITT) N=5310, 5181. 5246
GroupValue95% CI
Celecoxib-11.3± 29.11
Ibuprofen-11.3± 29.10
Naproxen-11.7± 29.33
Change-Baseline to Mon24 (ITT) N=4818, 4776, 4785
GroupValue95% CI
Celecoxib-11.3± 29.44
Ibuprofen-11.5± 28.98
Naproxen-11.4± 29.27

Adverse events — posted to ClinicalTrials.gov

Time frame: Adverse events were reported from the signing of the informed consent throughout the entire study period (42 months) and including 30 calendar days after the last administration of the investigational product.. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Celecoxib
Serious: 1473/8030 (18%)
Deaths:
Ibuprofen
Serious: 1624/7992 (20%)
Deaths:
Naproxen
Serious: 1611/7933 (20%)
Deaths:

Serious adverse events (1222 terms)

ReactionSystemCelecoxibIbuprofenNaproxen
OsteoarthritisMusculoskeletal and connective tissue disorders
Chest painGeneral disorders
PneumoniaInfections and infestations
Myocardial infarctionCardiac disorders
Angina unstableCardiac disorders
Coronary artery diseaseCardiac disorders
ArthralgiaMusculoskeletal and connective tissue disorders
Cardiac failure congestiveCardiac disorders
Atrial fibrillationCardiac disorders
Cerebrovascular accidentNervous system disorders
Acute kidney injuryRenal and urinary disorders
HypertensionVascular disorders
AnaemiaBlood and lymphatic system disorders
ArthritisMusculoskeletal and connective tissue disorders
CellulitisInfections and infestations
SyncopeNervous system disorders
Chronic obstructive pulmonary diseaseRespiratory, thoracic and mediastinal disorders
Transient ischaemic attackNervous system disorders
CholelithiasisHepatobiliary disorders
DyspnoeaRespiratory, thoracic and mediastinal disorders
Non-cardiac chest painGeneral disorders
Acute myocardial infarctionCardiac disorders
Urinary tract infectionInfections and infestations
GastroenteritisInfections and infestations
Renal failureRenal and urinary disorders
Other adverse events (16 terms — click to expand)

ReactionSystemCelecoxibIbuprofenNaproxen
HypertensionVascular disorders
OsteoarthritisMusculoskeletal and connective tissue disorders
ArthralgiaMusculoskeletal and connective tissue disorders
DiarrhoeaGastrointestinal disorders
Upper respiratory tract infectionInfections and infestations
Back painMusculoskeletal and connective tissue disorders
NauseaGastrointestinal disorders
BronchitisInfections and infestations
Pain in extremityMusculoskeletal and connective tissue disorders
Urinary tract infectionInfections and infestations
DyspepsiaGastrointestinal disorders
SinusitisInfections and infestations
HeadacheNervous system disorders
ConstipationGastrointestinal disorders
AnaemiaBlood and lymphatic system disorders
Gastrooesophageal reflux diseaseGastrointestinal disorders

Most-reported serious reactions: Osteoarthritis, Chest pain, Pneumonia, Myocardial infarction, Angina unstable, Coronary artery disease, Arthralgia, Cardiac failure congestive.

Data from ClinicalTrials.gov NCT00346216 adverse events section.

Sponsor's own description

To answer the question of overall benefit: risk of celecoxib when compared to two most commonly prescribe traditional (non-selective) nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of arthritis pain. For this purpose, patients with osteoarthritis or rheumatoid arthritis with or at risk of developing cardiovascular disease will be recruited. The cardiovascular, gastrointestinal and renal safety and symptomatic benefit in each treatment group will be assessed accordingly.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Cardiovascular Safety of Celecoxib, Naproxen, or Ibuprofen for Arthritis.
    Nissen SE, Yeomans ND, Solomon DH, Lüscher TF, et al · · 2016 · cited 518× · PMID 27959716 · DOI 10.1056/nejmoa1611593
  2. The interplay between inflammation and metabolism in rheumatoid arthritis.
    Chimenti MS, Triggianese P, Conigliaro P, Candi E, et al · · 2015 · cited 138× · PMID 26379192 · DOI 10.1038/cddis.2015.246
  3. Pharmacological modulation of the AKT/microRNA-199a-5p/CAV1 pathway ameliorates cystic fibrosis lung hyper-inflammation.
    Zhang PX, Cheng J, Zou S, D'Souza AD, et al · · 2015 · cited 80× · PMID 25665524 · DOI 10.1038/ncomms7221
  4. Differential blood pressure effects of ibuprofen, naproxen, and celecoxib in patients with arthritis: the PRECISION-ABPM (Prospective Randomized Evaluation of Celecoxib Integrated Safety Versus Ibuprofen or Naproxen Ambulatory Blood Pressure Measurement) Trial.
    Ruschitzka F, Borer JS, Krum H, Flammer AJ, et al · · 2017 · cited 74× · PMID 29020251 · DOI 10.1093/eurheartj/ehx508
  5. Differential impairment of aspirin-dependent platelet cyclooxygenase acetylation by nonsteroidal antiinflammatory drugs.
    Li X, Fries S, Li R, Lawson JA, et al · · 2014 · cited 56× · PMID 25385584 · DOI 10.1073/pnas.1406997111
  6. Risk of new acute myocardial infarction hospitalization associated with use of oral and parenteral non-steroidal anti-inflammation drugs (NSAIDs): a case-crossover study of Taiwan's National Health Insurance claims database and review of current evidence.
    Shau WY, Chen HC, Chen ST, Chou HW, et al · · 2012 · cited 34× · PMID 22297085 · DOI 10.1186/1471-2261-12-4
  7. Effect of Aspirin Coadministration on the Safety of Celecoxib, Naproxen, or Ibuprofen.
    Reed GW, Abdallah MS, Shao M, Wolski K, et al · · 2018 · cited 30× · PMID 29673465 · DOI 10.1016/j.jacc.2018.02.036
  8. Identifying and addressing safety signals in clinical trials.
    Fleming TR. · · 2008 · cited 30× · PMID 18768938 · DOI 10.1056/nejme0807372

Verify or expand the search:

Other trials of celecoxib

Trials testing the same drug.

Other recruiting trials for Arthritis, Rheumatoid

Currently open trials in the same condition.

Other Pfizer's Upjohn has merged with Mylan to form Viatris Inc. trials

Trials by the same sponsor.

Verify against primary sources

Data sources for this page

Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT00346216.

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing