HONG KONG, CHINA -- January 3, 2003 -- The arthritis drug celecoxib (marketed as Celebrex) is no more effective in preventing repeated bleeding from stomach ulcers than standard treatments, according to an article published yesterday in the New England Journal of Medicine (Volume 347: 2104-2110; December 26, 2002; Number 26). Celebrex reduces pain, swelling, and soreness in patients with osteoarthritis (age-related "wear and tear" on bones and joints) and rheumatoid arthritis. The manufacturer, Pharmacia, had touted the use of Celebrex as safer for those with ulcers than the use of other pain medications.
The study included 287 arthritis patients who had suffered from ulcers. Within this group, 144 received celecoxib in the form of Celebrex and 143 received other medication (the painkiller diclofenac plus the ulcer drug omeprazole). Ulcer bleeding occurred in 7 patients receiving celecoxib and 9 receiving diclofenac plus omeprazole. The researchers concluded that the difference was not statistically significant. Celecoxib or Celebrex was no more effective than the combination of diclofenac plus omeprazole in preventing repeated bleeding.
Celebrex is a non-steroidal anti-inflammatory drug (NSAID) that blocks the enzyme Cox-2. Celebrex was supposed to be safer than other NSAIDs such as ibuprofen that block both Cox-2 and the enzyme Cox-1. According to the Federal Food and Drug Administration's latest description of Celebrex, however, Celebrex and other Cox-2 inhibitors "can cause stomach ulcers that bleed." It warns that the chance of bleeding ulcers "increases the longer you take Celebrex and with higher doses of Celebrex."
Other serious Celebrex side-effects may include liver damage, kidney problems, and water retention. An article in the Journal of the American Medical Association also questions whether Cox-2 inhibitors can cause heart problems and stroke (Volume 286: 954-959; August, 2001).