Osteoarthritis Treatment
Abstract #1907 Celecoxib is associated with lower incidence of serious GI toxicity relative to non-steriodal antiinflammatory drugs (NSAIDS)- The Celecoxib long-term arthritis safety study (CLASS) F Silverstein, L Simon for the CLASS investigators, Seattle WA, Boston, MA and Skokie IL.
A randomized, double blind prosepective study was performed with 7,968 patients receiving celecoxib 400 mg bid (twice the maximum dose approved for RA), ibuprofen 800 mg tid or diclofenac 75 mg bid for a minimum of 6 months. Patients had either RA or OA. Results of the following GI outcomes were obtained:
Office evaluations for potential GI events
| Celecoxib | 12.6% | p<0.001 |
| NSAID comparators | 16% |
Consultative evaluations and diagnostic procedures
| Celecoxib | 2.8% | p<0.001 |
| NSAID comparators | 3.7% |
Symptomatic ulcers and ulcer complications
| Celecoxib | 2.1% | p=0.023 | 1.4% | p=0.017 |
| NSAID comparators | 3.5% | 2.9% |
Editorial comment: Similar to the VIGOR trial with rofecoxib, this study again shows the benefit of the selective COX-2 inhibitors over the older non-selective NSAIDs for GI toxicity. The incidence of GI events appears lower in this study for all the treatment groups and may reflect the fact that the VIGOR trial studied only RA patients and patients had a higher use of prednisone. The NSAID comparator group was not broken out into those receiving ibuprofen versus diclofenac.
