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Efficacy of celecoxib on controlling irregular uterine bleeding secondary to Jadelle use
Kritsana Buasang1, Surasak Taneepanichskul
1Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Insights
Celecoxib effectively controlled irregular uterine bleeding in Jadelle users, stopping bleeding within seven days for 70% of participants. This nonsteroidal anti-inflammatory drug (NSAID) offers a safe and satisfactory short-term solution for managing bleeding irregularities.
Area of Science:
- Reproductive Medicine
- Pharmacology
Background:
- Irregular uterine bleeding is a common side effect of Jadelle (a progestin-only contraceptive implant).
- Effective management strategies are needed to improve user satisfaction and continuation rates.
Purpose of the Study:
- To compare the efficacy of celecoxib versus placebo in controlling irregular uterine bleeding among Jadelle users.
- To assess patient satisfaction and adverse effects associated with celecoxib treatment.
Main Methods:
- A randomized, double-blind, placebo-controlled trial was conducted.
- Forty Jadelle users experiencing irregular bleeding were randomized into two groups: celecoxib (200 mg/day for 5 days) or placebo.
- Participants recorded bleeding patterns, side effects, and satisfaction levels daily.
Main Results:
- Celecoxib significantly increased the percentage of subjects with stopped bleeding within 7 days (70% vs. 0%, p < 0.001).
- The celecoxib group experienced longer bleeding-free intervals (24.0 days vs. 10.0 days) and shorter bleeding durations (5.0 days vs. 19.0 days) compared to placebo (p < 0.001).
- Patient satisfaction was significantly higher in the celecoxib group (80% vs. 30%, p < 0.001) with no detectable adverse effects.
Conclusions:
- Celecoxib demonstrates superior short-term efficacy over placebo for controlling irregular uterine bleeding in Jadelle users.
- The mechanism likely involves COX-2 inhibition by nonsteroidal anti-inflammatory drugs (NSAIDs), reducing endometrial bleeding.
Objective:
To evaluate the efficacy of celecoxib and placebo for controlling irregular uterine bleeding in Jadelle users.
Design:
Randomized double blind placebo controlled trial.
Setting:
Family Planning Clinic, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Material And Method:
Forty Jadelle users with irregular bleeding were randomly allocated into two groups. Twenty users received celecoxib 200 mg once a day for five days and the other twenty users received the placebo in the same manner The participants were requested to maintain their daily record of bleeding, adverse effects, and satisfaction.
Results:
The percentage of the subjects whom bleeding was stopped within 7 days after initial treatment was significantly higher in the celecoxib group than in the placebo group (70% vs. 0%; p < 0.001). The mean duration of bleeding-free interval was significantly longer in celecoxib than placebo group (24.0 +/- 1.65 days vs. 10.0 +/- 6.50 days; p < 0.001). The mean duration of bleeding days was significantly shorter in celecoxib than placebo group (5.0 +/- 1.65 vs. 19.0 +/- 6.50 days; p < 0.001). Patients satisfaction in celecoxib group was significantly higher than the placebo group (80% vs. 30%; p < 0.001). There was no detectable adverse effect in both groups.
Conclusions:
Celecoxib was more effective than placebo in the short-term control of irregular bleeding in Jadelle users. The mechanism of nonsteroidal anti-inflammatory drugs (NSAIDs) for the reduction of endometrial bleeding is likely from COX-2 inhibition.
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