The Pharmaceutical Journal
Vol 268 No 7189 p349-354
16 March 2002

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The Lancet (www.thelancet.com)

First case of fatal vasculitis with celecoxib reported

French doctors report the first case of fatal allergic vasculitis associated with celecoxib (Celebrex) in a research letter published in The Lancet last week (2001;359:852).

A previously healthy patient died from multiple organ failure following diffuse thrombotic vasculitis, having started treatment with the cyclo-oxygenase-2 selective inhibitor about 14 days earlier.

Although the doctors have no conclusive evidence, they suggest two possible mechanisms for the reaction: an allergic reaction due to the structure of the drug, and the promotion of a prothrombotic state resulting from inhibition of prostacycline synthesis.

A spokesman for Pharmacia and Pfizer, co-promoters of celecoxib, said that the companies continued to have confidence in the drug's safety profile.

All suspected reactions to celecoxib should be reported via the yellow card scheme.