Also Celebrex Safer Than Conventional NSAIDS
The drug Celebrex (celecoxib) is less likely to cause ulcers, gastrointestinal bleeding, and other toxic effects, than conventional nonsteroidal anti-inflammatory drugs (NSAIDs) report researchers in a new study.
The report is part of the Celecoxib Long-term Arthritis Safety Study (CLASS), a double-blind, randomized controlled trial, funded by the drug's manufacturer Pharmacia, conducted from September 1998 to March 2000.
Researchers analyzed data, on patients with either osteoarthritis (OA) or rheumatoid arthritis (RA), from 386 clinical sites in the US and Canada.
Of the 8059 patients originally enrolled in the study, 7968 received at least 1 dose of study drug, and 4573 patients (57%) received treatment for 6 months.
Patients were randomly assigned to receive celecoxib, 400 mg twice per day; ibuprofen, 800 mg 3 times per day; or diclofenac (another NSAID), 75 mg twice per day.
Patients were also permitted to take a daily dose of aspirin use for cardiovascular prophylaxis (325 mg/d).
The researchers note that "Conventional nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with a spectrum of toxic effects," something which many patients are likely unaware of.
The results of the study revealed annual incidence rates of upper GI ulcer complications alone (1st figure) and combined with symptomatic ulcers (2nd figure) for celecoxib vs. NSAIDs as follows:
Totals:
Celebrex - 0.76% vs. 1.45% NSAIDs - 2.08% vs 3.54%
Non-Aspirin Users:
Celebrex - 0.44% vs. 1.27% NSAIDs - 1.40% vs. 2.91%
Aspirin Users:
Celebrex - 2.01% vs. 2.12% NSAIDs - 4.70% vs. 6.00%
The most obvious and striking thing about these results is the tremendous rise in risk of aspirin users. For patients taking Celebrex, daily aspirin use raised the GI complication risks up to 450%. For patients taking NSAIDs, daily aspirin use raised the risks up to 335%.
Additionally, fewer celecoxib-treated patients than NSAID-treated patients experienced chronic GI blood loss, GI intolerance, liver toxicity, or kidney damage.
The authors note that "No difference was noted in the incidence of cardiovascular events between celecoxib and NSAIDs, irrespective of aspirin use."
JAMA September 13, 2000;284:1247-1255
Although this study seems to show that Cox-2 inhibitors such as Celebrex cause less GI complications, even more clinically important is the fact that this study shows both the dangers of daily aspirin use AND its ineffectiveness in preventing heart disease.
Celebrex is one of the most widely used drugs in the world. It clearly seems to cause fewer side effects than the other anti-inflammatory medications. However, in most nearly every case it is being used as a Band-Aid and is not addressing the underlying causal factors.
The diet is usually one of the most important foundational issues to help reduce the need for these types of medications. However, usually more aggressive interventions are required. For rheumatoid arthritis I find my revision of the antibiotic protocol of Dr. Brown seems to work quite well for most.
For osteoarthritis, glucosamine and chondroitin works quite nicely, as does exercise. A just-published study states that:
Both exercise and combined weight loss and exercise regimens lead to improvements in pain, disability, and performance. Moreover, the trends in the biomechanical data suggest that exercise combined with diet may have an additional benefit in improved gait compared with exercise alone. (J Am Geriatr Soc 2000 Sep;48(9):1062-72).
Additional factors are that can be addressed are usually identified through diagnostic strategies like Data Collection of the Autonomic Nervous System
A simple alternative Band-Aid to drugs like Celebrex would be topical Cilantro by Dragon River. It is quite amazing and a dropper application rubbed over the joint relieves most of the pain for about 24 hours.
It is also worthwhile noting that this study was funded by Celebrex manufacturer Pharmacia and that ALL authors either are employees or paid consultants of the company.
Another concern with Celebrex is its fluoride content. As illustrated in another article this week, fluoride is a very toxic substance and should be avoided. The fluoride content of the drug is not a contamination issue, nor is it in dispute. Each molecule of celecoxib (Celebrex) has 3 atoms of fluorine.
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