The safety of celecoxib in ankylosing spondylitis treatment

Expert Opin Drug Saf. 2008 Jul;7(4):401-9. doi: 10.1517/14740338.7.4.401.

Abstract

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) play a crucial role in the treatment of ankylosing spondylitis (AS). Most of the AS patients require a continuous and long-term NSAIDs therapy; therefore the question of NSAIDs safety in this population becomes very important.

Objective: to review the safety of celecoxib in ankylosing spondylitis treatment.

Methods: The PubMed database was searched using the keywords 'ankylosing spondylitis' and 'celecoxib', with the following extraction of clinical trials investigating efficacy and safety of celecoxib in AS.

Results/conclusions: Four clinical trials were found: three randomized controlled trials (RCTs) and one open-label extension of a previous RCT. All RCTs showed a good safety profile for celecoxib treatment in AS, similar to that of nonselective NSAIDs. However, long-term (>or= 1 year) celecoxib safety in AS was not investigated in RCTs. Based on the results of long-term non-AS celecoxib studies, most of the AS patients (because of young age and fewer comorbidities) are probably at low risk for cardiovascular and gastrointestinal complications. Celecoxib showed a good efficacy and safety profile in AS, but further investigations are needed to clarify the long-term safety of celecoxib in this group of patients.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Anti-Inflammatory Agents, Non-Steroidal / pharmacokinetics
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Celecoxib
  • Clinical Trials as Topic
  • Cyclooxygenase Inhibitors / adverse effects
  • Cyclooxygenase Inhibitors / pharmacokinetics
  • Cyclooxygenase Inhibitors / therapeutic use
  • Humans
  • Pyrazoles / adverse effects*
  • Pyrazoles / pharmacokinetics
  • Pyrazoles / therapeutic use
  • Risk Factors
  • Spondylitis, Ankylosing / drug therapy*
  • Sulfonamides / adverse effects*
  • Sulfonamides / pharmacokinetics
  • Sulfonamides / therapeutic use

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Cyclooxygenase Inhibitors
  • Pyrazoles
  • Sulfonamides
  • Celecoxib