Cardiovascular safety of celecoxib in rheumatoid arthritis and osteoarthritis patients: A systematic review and meta-analysis.

OBJECTIVE: To assess the cardiovascular safety of celecoxib compared to non-selective non-steroid anti-inflammatory drugs or placebo. METHODS: We included randomized controlled trials of oral celecoxib compared with a non-selective NSAID or placebo in rheumatoid arthritis and osteoarthritis patients. We conducted searches in EMBASE, Cochrane CENTRAL, MEDLINE, China National Knowledge Infrastructure, VIP, Wanfang, and Chinese Biomedical Literature Database. Study selection and data extraction were done by two authors independently. The risk of bias was assessed using Cochrane's risk-of-bias Tool for Randomized Trials. The effect size was presented as a risk ratio with their 95% confidence interval. RESULTS: Until July 22nd, 2021, our search identified 6279 records from which, after exclusions, 21 trials were included in the meta-analysis. The overall pooled risk ratio for Antiplatelet Trialists Collaboration cardiovascular events for celecoxib compared with any non-selective non-steroid anti-inflammatory drugs was 0.89 (95% confidence interval: 0.80-1.00). The pooled risk ratio for all-cause mortality for celecoxib compared with non-selective non-steroid anti-inflammatory drugs was 0.81 (95% confidence interval: 0.66-0.98). The cardiovascular mortality rate of celecoxib was lower than non-selective non-steroid anti-inflammatory drugs (risk ratio: 0.75, 95% confidence interval: 0.57-0.99). There was no significant difference between celecoxib and non-selective non-steroid anti-inflammatory drugs or placebo in the risk of other cardiovascular events. CONCLUSION: Celecoxib is relatively safe in rheumatoid arthritis and osteoarthritis patients, independent of dose or duration. But it remains uncertain whether this would remain the same in patients treated with aspirin and patients with established cardiovascular diseases.

Comparison of two criteria for evaluating severity of community-acquired pneumonia in China / 中华全科医师杂志

Objectives To understand current status of the admission and treatment for the patients with community-acquired pneumonia (CAP) in central hospitals of Shanghai area,and to evaluate the severity of patients admitted to the hospital with CAP by the criteria set in the Guidelines for Diagnosis and Treatment for CAP developed by the Chinese Medical Association in 2006 and provide evidence for its popularization and application throughout the country.Methods Medical records of 137 patients with CAP admitted to the hospital from January 1,2005 to September 30,2006 were retrospectively studied and analyzed with SPSS 10.0 software.Chi-square test and ANOVA were used to evaluate the severity of the patients with CAP by the criteria set in the Guidelines and to correlate it with pneumonia severity index (PSI).Statistical analysis was performed for the difference between length of hospitalization,cost,length of intravenous use of antibiotics,the number of risk factors,and fatality during hospitalization between three groups of patients categorized based on the severity criteria in the Guidelines.Results There existed a good relationship between the criteria for severity of CAP by the Guidelines and PSI,with a Pearson's coefficient of correlation of 0.577,P