The Pharmaceutical Journal
Vol 268 No 7186 p233-237
23 February 2002

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No increased risk of heart attacks with celecoxib

Treatment with celecoxib (Celebrex) does not increase risk of heart attack or stroke compared with other non-steroidal anti-inflammatory drugs, researchers say.

American researchers undertook a retrospective analysis of data from the celecoxib long-term arthritis safety study (CLASS). It involved nearly 8,000 patients who were randomised to receive celecoxib 400mg twice daily or a comparator NSAID (ibuprofen 800mg three times daily or diclofenac 75mg twice daily).

The analysis showed no significant difference between the celecoxib and NSAID groups in terms of overall events. The relative risk of any serious cardiovascular thromboembolic event in patients taking celecoxib versus those taking NSAIDs was 1.1. In addition, no difference in risk was found for a subgroup of patients who were not taking low-dose aspirin.

The researchers say: "This study does not support [a previous] hypothesis that COX-2 specific inhibition is associated with an increased risk of cardiovascular thromboembolic events." However, a question remains over whether there is a difference in cardiovascular event profile between celecoxib and another COX-2 specific inhibitor, rofecoxib. The researchers comment that the crude incidence of myocardial infarction associated with rofecoxib is higher than that associated with naproxen, diclofenac, ibuprofen or celecoxib. In addition, they point out that there is a difference in the effects of the two COX-2 specific inhibitors on hypertension and fluid retention (American Journal of Cardiology 2002;89:425).