Why the study?
The development of COX-2 specific NSAIDs aims to provide anti-inflammatory effects with fewer adverse effects on GI mucosa, platelets, and other organs, but their differential effects on hepatobiliary and platelet function remain to be evaluated.
Do different COX-2 inhibitors (celecoxib vs meloxicam) have differing effects on hepatobiliary function, platelet function, and uric acid levels in patients with osteoarthritis?
Cohort (n=48)
Open-label
No
Do different COX-2 inhibitors (celecoxib vs meloxicam) have differing effects on hepatobiliary function, platelet function, and uric acid levels in patients with osteoarthritis?
Different COX-2 inhibitors exhibit varying off-target effects on platelet function and uric acid levels, with meloxicam prolonging bleeding time more and celecoxib raising uric acid more.
Answers are grounded in this paper and cite their sources.
May warrant ALT and bleeding time monitoring with these agents in osteoarthritis; leaves open differential selection pending randomized data.
Background: The development of non steroidal anti-inflammatory drugs (NSAIDs) was based principally on inhibiting cyclooxygenases (COX) activity. However, the identification of twoCOX- isoforms (i.e., COX-1 and COX-2) with different physiological effects has led to the development of COX-2 specific NSAIDs, with fewer adverse effects than traditional NSAIDs.Therefore, They are expected to produce anti-inflammatory activity with minimal adverse effects on GI mucosa, as well as, other structures and cells such as platelets.The aim of this study is to evaluate the effect of selectivity of COX-2 inhibitors on many organs and systems function such as the hepatobiliary system, platelets function, as well as, serum uric acid levels.Patients and methods: Thirty six patients with osteoarthritis participated in this study. Twenty – four of them were treated with 400 mg celecoxib/day. The remainder received 15 mg meloxicam daily for 3 months .In addition to twelve apparently healthy subjects as a control . Measurement of serum alanine transaminase , serum alkaline phosphatase activity ,total serum protein, and serum albumin to evaluate hepatobiliary system . In addition to the estimation of bleeding time to evaluate the effect of selectivity of inhibitors to COX-2 on platelets function.Results: The results showed minor variations in their effects on liver function tests. However, meloxicam, the relatively selective COX-2 inhibitor affects bleeding time more than doescelecoxib, the purely COX-2 selective. Whereas, celecoxib elevated serum levels of uric acid more than meloxicam.Conclusion: We could conclude that selectivity to COX-2 enzyme has different odds of risks on pharmacological action.
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Hadi et al. (2010) conducted a cohort in Osteoarthritis (n=48). Celecoxib and Meloxicam vs. Healthy controls and baseline values was evaluated on Serum ALT levels (p=<0.05).
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