Safety of celecoxib compared with placebo and non-selective NSAIDs: cumulative meta-analysis of 89 randomized controlled trials

Essex, Margaret Noyes; Zhang, Richard Y; Berger, Manuela; Upadhyay, Sameer; Park, Peter W.

doi:10.1517/14740338.2013.780595

Cited by 36 publications

(26 citation statements)

References 43 publications

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“…Sadeghirad et al, 2017 evaluated the adverse reactions to corticosteroids and placebo in a meta-analysis where found that this king of drugs produces mild ad-verse effects [19]. NSAIDs have a large number of adverse effects which mainly affect the gastrointestinal tract, kidneys, and cardiovascular systems [20]. Patients taking therapeutic doses of NSAIDs and for a short period of time usually tolerate them well [21,22].…”

Section: Discussionmentioning

confidence: 99%

Pharmacological Control of Complications Following to Third Molar Removal: Evidence Based on A Meta-Analysis

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Pharmacological Control of Complications Following to Third Molar Removal: Evidence Based on A Meta-Analysis

et al. 2018

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“…The low magnitude of risk for adverse events with celecoxib and naproxen in this study was consistent with what has been demonstrated in a previous report. 19 A meta-analysis of 89 randomized, controlled studies in which celecoxib was compared with placebo or nonselective NSAIDs for pain and inflammation treatment showed that there was a greater risk of GI hemorrhage (risk difference: À0.53%), GI ulceration (À0.46%), edema (À0.62%) and hypertension (À0.57%) with nonselective NSAIDs than celecoxib. 19 Although there is a limited number of studies that have evaluated the safety of NSAIDs in Asian patients, differences in the frequencies of UGI events have been observed between treatments.…”

Section: Discussionmentioning

confidence: 99%

“…19 A meta-analysis of 89 randomized, controlled studies in which celecoxib was compared with placebo or nonselective NSAIDs for pain and inflammation treatment showed that there was a greater risk of GI hemorrhage (risk difference: À0.53%), GI ulceration (À0.46%), edema (À0.62%) and hypertension (À0.57%) with nonselective NSAIDs than celecoxib. 19 Although there is a limited number of studies that have evaluated the safety of NSAIDs in Asian patients, differences in the frequencies of UGI events have been observed between treatments. An analysis of 12 studies that compared celecoxib with loxoprofen in Japanese patients with OA or rheumatoid arthritis (RA) showed that there were significantly fewer serious GI events, including symptomatic ulcers, with celecoxib (P < 0.05).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of nonsteroidal anti‐inflammatory drugs in Asian patients with knee osteoarthritis: summary of a randomized, placebo‐controlled study

et al. 2015

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AimTo compare the efficacy, tolerability and safety of celecoxib, naproxen and placebo in Asian patients with osteoarthritis (OA) of the knee.MethodPatients of Asian descent with knee OA, aged ≥ 45 years, in a flare state with a functional capacity classification of I–III, received celecoxib 200 mg once daily, naproxen 500 mg twice daily or placebo, for 6 weeks. The change in Patient's Assessment of Arthritis Pain (week 6 vs. baseline) was the primary endpoint. Secondary endpoints, including Patient's and Physician's Global Assessments of Arthritis, Western Ontario and McMaster Universities OA Index (WOMAC), use of complementary and alternative medicines, incidence of treatment‐emergent adverse events (TEAEs) and measurements of upper gastrointestinal tolerability, were also assessed.ResultsThree hundred and sixty‐seven patients were randomized: 145 to celecoxib, 144 to naproxen and 78 to placebo. Celecoxib was as effective as naproxen in reducing OA pain (least squares mean change from baseline in visual analogue scale score [standard error] −37.1 [2.0] for celecoxib and −37.5 [2.0] for naproxen). Patient's and Physician's Global Assessment of Arthritis, WOMAC scores, Pain Satisfaction Scale and Patient Health Questionnaire‐9 showed statistically significant improvement in active treatment groups versus placebo, with the exception of naproxen WOMAC scores. Treatment‐related TEAEs occurred in 19 (13%), 34 (24%) and six (8%) patients in the celecoxib, naproxen and placebo groups, respectively.ConclusionCelecoxib and naproxen were comparable in their effects to reduce the signs and symptoms of knee OA in Asian patients. Celecoxib was shown to be safe and well tolerated in this patient population.

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“…PGE 2 is essential for maintaining stem cell-like cells in a number of tissues (Cha et al . 2006) and inhibiting the enzyme that degrades enhances regenerative capacity (Essex et al . 2013).…”

Section: Discussionmentioning

confidence: 99%

Celecoxib reduces glucocorticoids in vitro and in a mouse model with adrenocortical hyperplasia

Liu

Saloustros

Berthon

et al. 2015

Endocrine-Related Cancer

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Primary pigmented nodular adrenocortical disease (PPNAD), whether in the context of Carney complex (CNC) or isolated, leads to adrenocorticotropin hormone (ACTH) - independent Cushing’s syndrome (CS). CNC and PPNAD are caused typically by inactivating mutations of PRKAR1A, a gene coding for the type 1a regulatory subunit (R1α) of cAMP–dependent protein kinase (PKA). Mice lacking Prkar1a, specifically in the adrenal cortex (AdKO) developed CS caused by bilateral adrenal hyperplasia (BAH), which is formed from the abnormal proliferation of fetal-like adrenocortical cells. Celecoxib is a cyclooxygenase-2 (COX2) inhibitor. In bone, Prkar1a inhibition is associated with COX2 activation and prostaglandin E2 (PGE2) production that, in turn, activates proliferation of bone stromal cells. We hypothesized that COX2 inhibition may have an effect in PPNAD. In vitro treatment of human cell lines, including one from a patient with PPNAD, with Celecoxib resulted in decreased cell viability. We then treated AdKO and control mice with 1,500 mg/kg Celecoxib or vehicle. Celecoxib treatment led to decreased PGE2 and corticosterone levels, reduced proliferation and increased apoptosis of adrenocortical cells, and decreased steroidogenic gene expression. We conclude that, in vitro and in vivo, Celecoxib led to decreased steroidogenesis. In a mouse model of PPNAD, Celecoxib caused histological changes that reversed, at least in part, BAH and this was associated with a reduction of corticosterone levels.

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Safety of celecoxib compared with placebo and non-selective NSAIDs: cumulative meta-analysis of 89 randomized controlled trials

Abstract: The magnitude of risks associated with NSAIDs is small and similar in celecoxib-, nsNSAID- and placebo-treated patients. This analysis provides safety information that will allow physicians to make informed treatment decisions for patients who are appropriate candidates for celecoxib use.

Cited by 36 publications

References 43 publications

Pharmacological Control of Complications Following to Third Molar Removal: Evidence Based on A Meta-Analysis

Pharmacological Control of Complications Following to Third Molar Removal: Evidence Based on A Meta-Analysis

Efficacy and safety of nonsteroidal anti‐inflammatory drugs in Asian patients with knee osteoarthritis: summary of a randomized, placebo‐controlled study

Celecoxib reduces glucocorticoids in vitro and in a mouse model with adrenocortical hyperplasia

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