Both the NEJM (Nov 13, epub) and The Medical Letter (Dec. 19) reported on the cardiovascular safety of Celebrex. The NEJM publication concludes: “At moderate doses, celecoxib was found to be noninferior to ibuprofen or naproxen with regard to cardiovascular safety. In summary, the PRECISION trial also showed that celecoxib treatment also resulted in lower rates of gastrointestinal events than did either comparator drug and in lower rates of renal adverse events than did ibuprofen.” Click here to read full text. The Medical Letter (Dec. 19) reported that “the average dosage of the COX-2 selective NSAID celecoxib (Celebrex) used in the PRECISION trial was too low to support the determination that celecoxib is noninferior to ibruprofen and naproxen with regard to cardiovascular safety. Cox-2 selective NSAIDS cause less gastrointestinal toxicity and bleeding than nonselective NSAIDS, but they may have a prothromobotic effect, and all NSAIDS are nephrotoxic. Elderly patients, who are most at risk, should exercise caution in taking any NSAID, including celecoxib. To read Medical Letter piece, click here.