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The cardiovascular safety of celecoxib

Danny Liew1, Henry Krum

  • 1NHMRC Centre of Clinical Research Excellence in Therapeutics, Department of Medicine and Epidemiology, Monash University Central and Eastern Clinical School, Alfred Hospital, Melbourne, Victoria 3004, Australia. danny.liew@med.monash.edu.au

Future Cardiology
|October 7, 2009
PubMed

Insights

Celecoxib may slightly increase blood pressure, similar to non-NSAIDs, but less than rofecoxib. Evidence on celecoxib

Area of Science:

  • Pharmacology
  • Cardiovascular Medicine
  • Drug Safety

Background:

  • Rofecoxib withdrawal heightened concerns about cardiovascular risks of coxibs.
  • Celecoxib, a selective COX-2 inhibitor, requires scrutiny for its cardiovascular profile.

Purpose of the Study:

  • To review current evidence on celecoxib's cardiorenal and thromboembolic effects.
  • To compare celecoxib's cardiovascular risks with non-NSAIDs and rofecoxib.

Main Methods:

  • Review of existing evidence from observational studies and non-cardiovascular clinical trials.
  • Analysis of data concerning blood pressure, heart failure hospitalizations, and thromboembolic events.

Main Results:

  • Celecoxib may cause a slight increase in blood pressure, comparable to non-NSAIDs but less than rofecoxib.
  • Limited data suggest no increased risk of heart failure hospitalization, but further clinical studies are needed.
  • Evidence on thromboembolic effects is equivocal, with any potential increased risk appearing small and possibly similar to non-NSAIDs.

Conclusions:

  • Current evidence does not definitively establish increased cardiovascular risk for celecoxib compared to non-NSAIDs.
  • Purpose-designed randomized trials are necessary to definitively assess celecoxib's cardiovascular safety.
  • Switching from coxibs to non-NSAIDs for cardiovascular safety may be flawed if non-NSAIDs also increase risk.

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