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As compared to ns-NSAIDs
celecoxib is safer with better GI-tract tolerability and less cardiovascular
risks thus it can be a suitable option for chronic use.
According to recent research published in The Journal of Pain Research, the long-term use of a COX-2 selective nonsteroidal anti-inflammatory drug, Celecoxib provides a significant efficacy and excellent safety for chronic pain management among the patients at increased CV (cardiovascular) risk. According to the International Association for the Study of Pain, chronic pain is defined as "pain that continues beyond normal tissue healing time, which is supposed to be three months". Individuals with chronic pain have disturbed quality of life and face difficulty in doing day-to-day activities. The medications which used extensively to manage chronic pain are COX2-selective and nonselective (ns) nonsteroidal anti-inflammatory drugs (NSAIDs). Various NSAIDs associated with the risk of adverse CV and gastrointestinal (GI) differently.
A robust data on the relative CV and GI tolerability
profiles of currently present NSAIDs was assembled from two randomized
controlled trials (PRECISION and CONCERN) and an individual patient data
meta-analysis in 2017. The CONCERN explains Celecoxib was correlated with rare
adverse GI-tract events than Naproxen, and the PRECISION illustrates all the
medications, Celecoxib, Naproxen and Ibuprofen showed similar CV-event rates,
but Celecoxib exhibited better GI tolerability than any other drug. Further, as
per meta-analysis, no notable difference was seen in the acute myocardial
infarction rate between Celecoxib and ns-NSAIDs, but the only COX2-selective
NSAID which exhibited a lower risk of adverse CV and GI events as compared to
ns-NSAIDs was Celecoxib.
All this information regarding the relative tolerability of
different NSAIDs were used in this analysis to update the treatment algorithm.
The choice about whether to manipulate NSAID and which one should be on the
basis of the patient's risk of producing adverse GI and CV events. Upper and
lower-GI-tract events required to be considered. Out of all COX2-selective
NSAIDs, Celecoxib showed better lower-GI-tract tolerability than ns-NSAIDs and
a proton-pump inhibitor. Additionally, on the report of the latest data, the
long-term use of 200 mg/day Celecoxib may be suitable for subjects at extended
CV risk.
The Journal of Pain Research
Nonsteroidal anti-inflammatory drugs in chronic pain: implications of new data for clinical practice
Kok Yuen Ho et al.
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