Minor
Established
説明
Combining aspirin with celecoxib provides no additional gastroprotective benefit over aspirin alone and may negate the GI advantage of celecoxib, increasing the risk of mucosal injury.
機序
Aspirin inhibits COX-1 (and to a lesser extent COX-2), causing gastric mucosal injury; celecoxib's GI safety advantage over non-selective NSAIDs is largely lost when aspirin is co-administered.
臨床的意義
The CLASS trial showed that the GI safety advantage of celecoxib over diclofenac/ibuprofen was abolished when patients were on concurrent aspirin.
対処法
Add a PPI when using celecoxib + aspirin; if the primary goal is GI safety, combining celecoxib with aspirin defeats this purpose.