Canadian Study: Is Celebrex The Safest Anti-Inflammatory Drug?

Cardiovascular side effects differ between Celebrex, Vioxx, and older NSAIDs.

Celecoxib arthritis drug molecule
Celebrex for arthritis. LAGUNA DESIGN / Getty Images

This article is part of the Arthritis Archives.

Editor note: On 09/30/2004, Merck the maker of Vioxx, issued a worldwide recall, halting sales of the drug. On 04/07/2005, Following scrutiny of the class of arthritis drugs known as NSAIDs and COX-2 inhibitors, the FDA announced planned regulatory actions. 

Dateline: May 29, 2004

Canadian Study Shows Celebrex May Be Safest Anti-Inflammatory Drug For Older People

People who have symptoms of arthritis are often prescribed one of the non-selective, nonsteroidal anti-inflammatory drugs (NSAIDs) or one of the newer group of NSAIDS known as cyclo-oxygenase-2 inhibitors (COX-2 selective inhibitors).

Non-selective NSAIDs have been associated with an increased risk of congestive heart failure. Less is known or has been concluded about the cardiovascular effects of COX-2 selective inhibitors.

The Lancet (2004;363:1751-56) has revealed results of a Canadian study involving over 130,000 older people. Muhammad Mamdani from the Institute for Clinical Evaluative Sciences, Toronto, Canada, and colleagues did a retrospective analysis of the risk of hospital admission for heart failure for around:

  • 14,500 people using the COX-2 inhibitor Vioxx (rofecoxib)
  • 19,000 people using the COX-2 inhibitor Celebrex (celecoxib)
  • 5,400 people using non-selective NSAIDs
  • 100,000 people not using any NSAID served as the control group

Study Results

Compared with the control group of non-NSAID users, the results were:

  • People using Vioxx had an 80% increased risk of hospital admission for congestive heart failure.
  • People using non-selective NSAIDs had a 40% increased risk of admission for congestive heart failure.
  • People using Celebrex had the same rate of hospital admission for heart failure as people who had never used NSAIDs.

The differences between non-selective NSAIDS and individual COX-2 inhibitors respective to admission for congestive heart failure would seem to suggest the need for large-scale, randomized, controlled trials to facilitate further study.

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