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Celecoxib and Heart Attack

     Marketed by Pfizer under the brand name of Celebrex, Celecoxib is a COX-2 selective non-steroidal anti-inflammatory drug (NSAID) prescribed for the treatment of osteoarthritis, rheumatoid arthritis, acute pain during menstruation and to reduce the number of polyps in patients with familial adenomatous polyposis.

      Celecoxib belongs to a unique class of drugs called as Cox-2 inhibitors. Cyclooxygenase-2 or Cox-2 is the prime enzyme driving prostaglandins during an inflammatory reaction. Cox-2 inhibitors block this enzyme resulting in a lower concentration of prostaglandins. Cox-2 inhibitors are widely prescribed than any other NSAIDs because the gastro-intestinal side effects and ulceration of the stomach is less with these drugs. However, COX-2 inhibitors brand name Vioxx, have been found to cause cardiovascular problems including heart attack, blood clots, chest pain, cardiac arrest and stroke. Hence, companies like Merck and Pfizer were required to remove their Cox-2 inhibitor drugs from the market upon the recommendation of FDA. Celecoxib is currently the only available Cox-2 inhibitor drug in the market.

       Research data regarding the cardiovascular risks of Celecoxib is controversial. According to a clinical trial conducted in December 2004, an increased dosage of Celecoxib demonstrated an increased cardiovascular risk in comparison to a placebo. However, the same results were contradicted in another study that was named “PreSAP”. Numerous clinical trials are being carried out to find the cardiovascular risks associated with Celecoxib.

       Inspite of these findings, FDA continues to be apprehensive about the usage of this drug. Celecoxib is currently marketed with a “black box warning” indicative of causing cardiovascular ailments. According to American Heart Association, Celecoxib must be used as a final alternative in patients having history of cardiac arrest.

Celecoxib and Heart Attack

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