Minor
Established
Descrição
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.
Mecanismo
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.
Significância Clínica
The CLASS trial showed that the GI safety advantage of celecoxib over diclofenac/ibuprofen was abolished when patients were on concurrent aspirin.
Conduta
Add a PPI when using celecoxib + aspirin; if the primary goal is GI safety, combining celecoxib with aspirin defeats this purpose.