COX-2 inhibitors in sports medicine: utility and controversy

Buvanendran, Asokumar; Reuben, Scott S.

doi:10.1136/bjsm.2006.028944

Cited by 5 publications

(3 citation statements)

References 18 publications

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“…The prostaglandin pathway is primarily responsible for the release of mediators of inflammation so the treatment is focused on the inhibition of Cyclooxygenase (COX); thus Nonsteroidal AntiInflammatory Drugs (NSAIDs) block the COX-1 and COX-2 isoforms, and Celecoxib exclusively COX-2 [4]. Both groups are ideal for controlling sports injuries because they decrease excessive inflammation and pain [5].…”

Section: Introductionmentioning

confidence: 99%

Celecoxib 2% Cream in Acute Soft Tissue Injuries: Randomized, Double-blind, Placebo-controlled Clinical Trial

Geannyne¹,

Amador²,

Silvia³

et al. 2017

Clin Res Foot Ankle

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Objective: The aim of the study was to evaluate the efficacy of pain reduction and tolerability of topical administration of Celecoxib 2% cream compared to Celecoxib 1% cream and placebo cream in Mexican patients who had acute soft tissue injury in lower limbs. Methods:A randomized, double-blind, placebo control trial with 3 parallel groups was conducted. We include Mexicans patients older than 18 years with diagnosis of acute soft tissue injury in lower limbs. They were randomly assigned to Celecoxib 2% cream (CEL-2), Celecoxib 1% cream (CEL-1) or placebo cream (PLA). All treatments should be applied 3 times a day for a period of 7 days. Every day the pain was assessed with a Visual Analogue Scale (VAS). Secondary, we evaluate inflammation and adverse events.Results: A total of 95 patients were included. VAS on day 1 and 7 in group CEL-2 were 57.41 ± 10.39 mm and 4.34 ± 7.02 mm, in CEL-1 59.38 ± 9.37 mm and 10.41 ± 12.78 mm, and in PLA 55.61 ± 8.09 mm and 9.32 ± 9.93 mm. CEL-2 showed greater pain decrease compared to CEL-1 and PLA, p<0.05. CEL-1 group significantly decreased inflammation more than PLA, p<0.05. 15 adverse events were reported in 9 patients, none was severe. Conclusion:The results shown in the present study demonstrate that topical administration of Celecoxib cream 2%, TID for 7 days was effective in pain relief in patients with acute soft tissue injury.

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Section: Introductionmentioning

confidence: 99%

Celecoxib 2% Cream in Acute Soft Tissue Injuries: Randomized, Double-blind, Placebo-controlled Clinical Trial

Geannyne¹,

Amador²,

Silvia³

et al. 2017

Clin Res Foot Ankle

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“…The more recently developed selective COX‐2 inhibitors are in theory more appropriate and specific to dampen excessive inflammatory reactions than the non‐selective (COX‐1 and COX‐2) inhibitors (Warden, 2005). However, it has been demonstrated that these new drugs can also have negative long‐term effects on regeneration and healing in animals (Warden, 2005; Buvanendran & Reuben, 2006) – especially through inhibition of satellite cell activity in skeletal muscle (Bondesen et al, 2004; Shen et al, 2006). But there is presently no clear evidence for detrimental effects of COX‐2 inhibitors on regeneration and healing of injuries in humans (Reuben & Ekman, 2005, 2007; Warden, 2005; Mehallo et al, 2006; Vuolteenaho et al, 2008).…”

mentioning

confidence: 99%

A COX‐2 inhibitor reduces muscle soreness, but does not influence recovery and adaptation after eccentric exercise

Paulsen

Egner

Drange

et al. 2010

Scandinavian Med Sci Sports

103

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The aim of this study was to investigate the effect of a cyclooxygenase (COX)-2 inhibitor on the recovery of muscle function, inflammation, regeneration after, and adaptation to, unaccustomed eccentric exercise. Thirty-three young males and females participated in a double-blind, placebo-controlled experiment. Seventy unilateral, voluntary, maximal eccentric actions with the elbow flexors were performed twice (bouts 1 and 2) with the same arm, separated by 3 weeks. The test group participants were administered 400 mg/day of celecoxib for 9 days after bout 1. After both bouts 1 and 2, concentric and isometric force-generating capacity was immediately reduced (approximately 40-50%), followed by the later appearance of muscle soreness and increased serum creatine kinase levels. Radiolabelled autologous leukocytes (detected by scintigraphy) and monocytes/macrophages (histology) accumulated in the exercised muscles, simultaneously with increased satellite cell activity. These responses were reduced and recovery was faster after bout 2 than 1, demonstrating a repeated-bout effect. No differences between the celecoxib and placebo groups were detected, except for muscle soreness, which was attenuated by celecoxib. In summary, celecoxib, a COX-2 inhibitor, did not detectably affect recovery of muscle function or markers of inflammation and regeneration after unaccustomed eccentric exercise, nor did the drug influence the repeated-bout effect. However, it alleviated muscle soreness.

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“…5,6,47 A review of the above studies certainly suggests that the anti-inflammatory agents and indeed both the non-selective NSAIDs and the COXIBs have a significant negative effect on musculoskeletal tissue healing and this finding remains a subject of much debate. 40,[48][49][50] This is particularly evident with respect to animal study models. Whilst animal studies are important precursors in initial evaluation of drug safety and efficacy, care should be taken in extrapolating the results in many of these laboratory based studies to the clinical setting.…”

Section: Ligament Injurymentioning

confidence: 99%

Pain management in sports medicine: Use and abuse of anti-inflammatory and other agents

Derman

Schwellnus

2010

South African Family Practice

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COX-2 inhibitors in sports medicine: utility and controversy

Cited by 5 publications

References 18 publications

Celecoxib 2% Cream in Acute Soft Tissue Injuries: Randomized, Double-blind, Placebo-controlled Clinical Trial

Celecoxib 2% Cream in Acute Soft Tissue Injuries: Randomized, Double-blind, Placebo-controlled Clinical Trial

A COX‐2 inhibitor reduces muscle soreness, but does not influence recovery and adaptation after eccentric exercise

Pain management in sports medicine: Use and abuse of anti-inflammatory and other agents

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