Objective To evaluate the efficacy and safety of Celecoxib and Naproxen for treating osteoarthritis or rheumatoid arthritis.Methods Such databases as EMbase, PubMed, The Cochrane Library, Chinese Biomedical Literature Database (CBM), China Journal Full-text Database (CJFD), and Chinese Scientific Journal Full-text Database (CSJD) were searched to collect the randomized controlled trials (RCTs) of Celecoxib and Naproxen for treating osteoarthritis or rheumatoid arthritis. Two reviewers independently assessed the quality of the included studies and extracted the data. The Review Manager (version 5.0) software was used to analyze the data. Results Four RCTs involving 2 931 patients were included. The results of meta-analyses were as follows: a) There were significant differences in the dose of Celecoxib and Naproxen for treating rheumatoid arthritis or osteoarthritis; b) There was no significant difference in gastrointestinal reaction between the Celecoxib group and the placebo group (RR=1.29, 95%CI 0.93 to 1.79); c) The were significant differences in gastrointestinal reaction between the Celecoxib group and the Naproxen group (RR=0.78, 95%CI 0.64 to 0.95); d) There were significant differences in inducing the severity of Stomach and Duodenum Endoscopy Score between the Celecoxib group and the Naproxen group when treating rheumatoid arthritis or osteoarthritis (RR=1.29, 95%CI 0.93 to 1.79). As the Intention-To-Treat (ITT) analysis showed, there were significant differences in inducing the severity of gastrointestinal reaction between the Celecoxib group and the Naproxen group when treating rheumatoid arthritis or osteoarthritis (RR=0.84, 95%CI 0.77 to 0.92). Conclusion Compared with Naproxen, there are significant differences in efficacy for treating rheumatoid arthritis and osteoarthritis with Celecoxib in different doses. The Celecoxib has no significant difference in gastrointestinal reaction compared with the placebo group. The Celecoxib group has fewer gastrointestinal side-effects as compared with the Naproxen group, so it can be used to treat rheumatoid arthritis and osteoarthritis in clinic. The results still need to be confirmed by high-quality RCTs.
