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February 2006
Short-term Celebrex seems safe for osteoarthritis
February 27, 2006
NEW YORK (Reuters Health) - The COX-2 inhibitor
Celebrex (celecoxib) causes fewer gastrointestinal complications
than traditional nonsteroidal anti-inflammatory painkillers
or NSAIDs, without raising the risk of cardiovascular events,
according to results of a large, prospective, 3-month trial.
Some clinical trials have demonstrated increased cardiovascular
risk associated with other COX-2 inhibitors, which led to
the withdrawal of two from the market -- Vioxx (rofecoxib)
and Bextra (valdecoxib). Results of one study suggested
that Celebrex, given in large doses (800 mg/day) over prolonged
periods of time, may also have a worse cardiovascular risk
profile than nonspecific NSAIDs, whereas other studies showed
no such risk.
The Successive Celecoxib Efficacy and Safety Study-1 (SUCCESS-1),
conducted in 39 countries, enrolled 13,194 patients with
osteoarthritis of the hip, knee or hand of at least 6 months
duration.
The investigators, led by Dr. Gurkirpal Singh from Stanford
University School of Medicine in California, randomized
patients to Celebrex (100 or 200 mg twice daily), the NSAID
naproxen (500 mg twice daily) or the NSAID diclofenac (50
mg twice daily). Treatment lasted for 12 weeks.
The researchers report in the American Journal of Medicine
for March that all treatments were similarly effective in
reducing pain. Moreover, Celebrex 100 mg twice daily was
comparable to Celebrex 200 mg twice daily.
The incidence of serious upper gastrointestinal events was
1.0 per 100 patient-years in the NSAID groups and 0.2 per
100 patient-years in the Celebrex groups (odds ratio 6.02).
Although numerical differences were seen, there was no statistically
significant difference between Celebrex and NSAIDs in any
cardiovascular adverse event rate, except that the rate
of heart failure was higher in the NSAID group.
When making recommendations for treatment of osteoarthritis,
Singh's group advises, "clinicians should consider
a number of factors, including the risk for upper gastrointestinal
events, duration of therapy, as well as costs, before deciding
upon individual patient treatment."
For more information, visit: http://today.reuters.co.uk/news/newsArticle.aspx?type=healthNews&storyID=2006-02-27T181247Z_01_COL765452_RTRIDST_0_HEALTH-CELEBREX-OSTEOARTHRITIS-DC.XML&archived=False
