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Published on: May 16, 2025
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Celecoxib for rheumatoid arthritis.
Mahir Fidahic1, Antonia Jelicic Kadic, Mislav Radic
1Medical faculty, University of Tuzla, Univerzitetska 1, Tuzla, Canton Tuzla, Bosnia and Herzegovina, 75000.
The Cochrane Database of Systematic Reviews
|June 10, 2017
Summary
Celecoxib may improve rheumatoid arthritis symptoms and reduce pain compared to placebo, with fewer patient withdrawals. However, evidence on harms like ulcers and cardiovascular events remains uncertain, necessitating further research.
Area of Science:
- Rheumatology
- Pharmacology
Background:
- Rheumatoid arthritis is a chronic autoimmune disease causing joint inflammation.
- Current treatments manage symptoms like pain and stiffness, aiming for remission and improved mobility.
- Celecoxib, a selective NSAID, is used to treat rheumatoid arthritis.
Purpose of the Study:
- To evaluate the benefits and harms of celecoxib in rheumatoid arthritis patients.
- To compare celecoxib with placebo and traditional NSAIDs (tNSAIDs).
Main Methods:
- Systematic review of randomized controlled trials (RCTs).
- Searched major databases including Cochrane CENTRAL, MEDLINE, and Embase up to May 2017.
- Included 8 RCTs (3988 adults) comparing oral celecoxib (200-400 mg/day) against placebo or tNSAIDs.
Main Results:
- Celecoxib showed significant clinical improvement and pain reduction versus placebo (moderate to low quality evidence).
- Celecoxib led to fewer patient withdrawals compared to placebo.
- Compared to tNSAIDs, celecoxib showed a lower incidence of gastroduodenal ulcers but similar effects on pain and physical function (moderate quality evidence).
- Evidence on serious adverse events and cardiovascular events was uncertain for both comparisons.
Conclusions:
- Celecoxib may improve rheumatoid arthritis symptoms and pain versus placebo, with fewer withdrawals.
- Celecoxib may offer slight symptom improvement over tNSAIDs and significantly reduces gastroduodenal ulcers.
- Uncertainty regarding cardiovascular risks and serious adverse events necessitates larger, head-to-head trials.
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