Medicus, Vol. 24 No. 2 ASK niske doze, 2015.
Review article
Celecoxib – the First Selective COX-2 Inhibitor in Clinical Practice
Simeon Grazio
Abstract
Celecoxib is a non-steroidal antirheumatic (NSAR) and the first selective cyclooxygenase-2 (COX-2) inhibitor in clinical practice. The product is registered in a number of countries, including Croatia, for symptomatic treatment of osteoarthritis, rheumatoid arthritis and ankylosing spondylitis in adults. In randomized controlled trials, the efficiency of celecoxib administered in recommended daily doses of 200 and 400 mg was significantly better than that of placebo, equal to or higher than that of paracetamol and comparable to that of non-selective or other selective COX-2 inhibitors. Generally, celecoxib is well tolerated, causing mild to moderate gastrointestinal disorders, which are also its most common side effects. In large studies and meta-analyses, the incidence of complicated upper GI ulcers during the administration of recommended celecoxib doses was significantly lower than during the administration of non-selective NSARs. Although the results of a randomized polyp prevention trial showed an increased cardiovascular risk when celecoxib was administered in daily doses of 400 and 800 mg, these results were statistically significant only for patients with previous atherosclerotic disease. It should be emphasized, however, that the majority of non-selective NSARs also increase cardiovascular risk. To minimise risks, particularly cardiovascular risks, all NSARs (non-selective and COX-2 selective) should be preferably administered in a minimum effective dose and following a careful risk assessment for each individual patient.
Keywords
celecoxib; treatment; pain; gastrointestinal; cardiovascular
Hrčak ID:
148324
URI
Publication date:
4.11.2015.
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