Cardiorenal Effects of Newer NSAIDs (Celecoxib) versus Classic NSAIDs (Ibuprofen) in Patients with Arthritis

Abstract

Background. Arthritis is a common condition that co-exists in the elderly population. This condition leads to frequent administration of comorbid analgesics especially non steroidal anti-inflammatory drugs (NSAIDs). Aim. To study cardiorenal toxicity of celecoxib versus ibuprofen in arthritic patients. Subjects and Methods. Seven hundred ninety-wo arthritic patients were enrolled in the study for 6 months. Three hundred ninety-six patients administered celecoxib 400 mg twice a day; 396 patients administered ibuprofen 300 mg three times a day. Effects measured included investigator-reported hypertension, edema, or congestive heart failure, increases in serum creatinine or reduction in serum creatinine clearance, and changes in serum electrolytes. Results. Celecoxib was associated with significant (P < .05) lower incidence of hypertension and edema in comparison with ibuprofen. Systolic hypertension occurred significantly less (P < .05) with celecoxib compared with ibuprofen. Serum creatinine was significantly increased (P < .05) in patients treated with ibuprofen in comparison with celecoxib. Creatinine clearance was significantly lower (P < .05) in cases treated with ibuprofen in comparison to celecoxib. Nonsignificant changes in serum body electrolytes occurred. Conclusion. The most important finding of this study was the lowering incidence of cardiorenal toxicity of celecoxib in comparison with ibuprofen.

How safe is Celecoxib for Asian–Indian patients with rheumatic diseases?

“…The most significant observation in this cohort was the development of new onset hypertension in young patients using Celecoxib, as compared to those who had used non-selective NSAIDs. This finding is in stark contrast to two other studies which have shown Celecoxib to have a significantly lower incidence of hypertension when compared to ibuprofen, 17 and an equal risk of developing new onset hypertension as compared to diclofenac. 18 No significant hypertension was observed in those Celecoxib users who had switched over to other non-selective NSAIDs.…”

Adverse Effects of Nonsteroidal Antiinflammatory Drugs: An Update of Gastrointestinal, Cardiovascular and Renal Complications

“…Any change in the renal function may influence CV system, hence, NSAIDs effect on the former may, in part, explain the complications seen in the latter (83) (84).…”

Correlation between perioperative parecoxib and postoperative acute kidney injury in patients undergoing non-cardiac surgery: a retrospective cohort analysis

“…COX-1 contributes to controlling renal GFR, whereas COX-2 is involved in sodium and water excretion [28]. COX-2 inhibitors are associated with mild hypertension owing to modest sodium retention in the rst days of therapy [29]. The renoprotective mechanism of parecoxib may be related to its antiin ammatory effects and sodium regulation.…”