The analysis of the PRECISION (Prospective Randomized Evaluation of Celecoxib Integrated Safety Versus Ibuprofen or Naproxen) trial revealed that Celecoxib has a more favourable overall safety profile as compared to Naproxen or Ibuprofen if administered without aspirin, as per a study issued in 'Journal of the American College of Cardiology'.The safety of nonsteroidal anti-inflammatory drug (NSAID) and aspirin when administered together is not certain. This study aimed to detect the difference in the safety of combining NSAIDs (Celecoxib, Naproxen, or Ibuprofen) with low-dose aspirin. This study included on-treatment patients. A total of 23,953 OA and RA patients with high cardiovascular risk were enrolled in the study. The study population was randomly assigned to the Ibuprofen, Celecoxib and Naproxen treatment. The outcomes comprised of composite major cardiovascular events, non-cardiovascular death, gastrointestinal or renal events.

The Cox proportional hazards models were used to compare the outcomes. The cumulative probability of events was analyzed using the Kaplan-Meier analysis.
As compared to Celecoxib, the Naproxen or Ibuprofen found to have a greater risk for the primary composite endpoint when taken without aspirin. The cardiovascular adverse effects were almost similar with all three NSAIDs. However, the ibuprofen found to exhibit more cardiovascular events as compared to celecoxib whereas GI and renal events were more seen with both naproxen and ibuprofen.

Thus, the study results prove that despite the difference in the extent of impairment of safety outcomes of celecoxib, ibuprofen and naproxen the co-administration of aspirin hinders the safety of these NSAIDs.