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Celecoxib has a superior upper‐gastrointestinal (GI) safety profile compared with nonselective nonsteroidal antiinflammatory drugs (NS‐NSAIDs). It is unclear whether the utilization of a proton‐pump inhibitor (PPI) with celecoxib confers additional protection in elderly patients. We assessed the association between GI hospitalizations and use of celecoxib with a PPI versus celecoxib alone, and NS‐NSAIDs with a PPI or NS‐NSAIDs alone in elderly patients.

We conducted a population‐based retrospective cohort study using the government of Quebec health services administrative databases. Elderly patients were included at their first dispensing date for celecoxib or an NS‐NSAID between April 1999 and December 2002. Prescriptions were separated into 4 groups: celecoxib, celecoxib plus PPI, NS‐NSAIDs, and NS‐NSAIDs plus PPI. Cox regression models with time‐dependent exposure …