PMID- 24692797
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140402
LR  - 20211021
IS  - 0011-393X (Print)
IS  - 0011-393X (Linking)
VI  - 69
IP  - 3
DP  - 2008 Jun
TI  - Role of selective cyclooxygenase-2 inhibitors in exacerbation of inflammatory 
      bowel disease: A systematic review and meta-analysis.
PG  - 181-91
LID - 10.1016/j.curtheres.2008.06.009 [doi]
AB  - BACKGROUND: In the general population, selective cyclooxygenase (COX)-2 
      inhibitors have been associated with fewer gastrointestinal adverse effects (AEs) 
      than NSAIDs, but whether they are associated with exacerbations in patients with 
      inflammatory bowel disease (IBD) remains controversial. OBJECTIVE: The aim of 
      this study was to review published and unpublished findings to determine whether 
      the use of COX-2 inhibitors increased the risk for IBD exacerbations relative to 
      placebo in the treatment of IBD. METHODS: A systematic search of MEDLINE 
      (1966-July 2007), EMBASE (1980-July 2007), the Cochrane Library (2007 Issue 4), 
      US Food and Drug Administration records, and data on file at Novartis 
      Pharmaceuticals Corporation, Pfizer US Pharmaceutical Group, and Merck & Co., 
      Inc., using the search terms celecoxib, rofecoxib, valdecoxib, etoricoxib, 
      lumiracoxib, cyclooxygenase 2 inhibitor, Crohn's disease, ulcerative colitis, and 
      inflammatory bowel disease, was performed to identify randomized, 
      placebo-controlled clinical trials of 5 COX-2 inhibitors in patients with IBD. 
      The publications were fully reviewed for quality. Data on trial design, patient 
      characteristics, intervention drugs, dosages, and outcomes were collected using a 
      predetermined data-extraction form. A meta-analysis was performed based on the 
      publications that met the inclusion/exclusion criteria. RESULTS: Of 588 studies 
      identified in the electronic search, 574 were excluded after screening the titles 
      and abstracts. Fourteen related to the use of COX-2 inhibitors in patients with 
      IBD were reviewed. Two randomized, controlled trials comparing COX-2 inhibitors 
      with placebo were identified. In the first trial, 82 patients were randomized to 
      receive etoricoxib (60-120 mg/d) and 77 to receive placebo. The exacerbation 
      rates were 10.5% (8/76) in the active-treatment group and 11.4% (8/70) in the 
      placebo group (relative risk [RR], 0.92; 95% CI, 0.37-2.32). In the second trial, 
      112 patients were treated with celecoxib (200 mg BID) and 110 received placebo. 
      The exacerbation rates were 3.7% (4/107) in the celecoxib group and 2.7% (3/110) 
      in the placebo group (RR, 0.73; 95% CI, 0.17-3.18). Of these patients, 5 were 
      lost to follow-up because of AEs. In the meta-analysis comparing COX-2 inhibitors 
      and placebo, the RR was 0.86 (95% CI, 0.39-1.88). No statistically significant 
      differences in IBD relapse rates were found between COX-2 inhibitors and placebo. 
      CONCLUSIONS: The results from this meta-analysis suggest that insufficient data 
      were available to determine the impact of COX-2 inhibitors on IBD exacerbations. 
      The relatively smaller risk for AEs makes the short-term use of COX-2 inhibitors 
      potentially attractive, but the long-term benefits remain unclear. Further 
      studies with sound methodology and large sample sizes are needed to evaluate the 
      tolerability of COX-2 inhibitors in the treatment of IBD.
FAU - Miao, Xin-Pu
AU  - Miao XP
AD  - Department of Gastroenterology, West China Hospital of Sichuan University, 
      Chengdu, China.
FAU - Ouyang, Qin
AU  - Ouyang Q
AD  - Department of Gastroenterology, West China Hospital of Sichuan University, 
      Chengdu, China.
FAU - Li, Hui-Yan
AU  - Li HY
AD  - Department of Chemotherapy for Cancer, West China Hospital of Sichuan University, 
      Chengdu, China.
FAU - Wen, Zhong-Hui
AU  - Wen ZH
AD  - Department of Gastroenterology, West China Hospital of Sichuan University, 
      Chengdu, China.
FAU - Zhang, De-Kui
AU  - Zhang DK
AD  - Department of Gastroenterology, West China Hospital of Sichuan University, 
      Chengdu, China.
FAU - Cui, Xiao-Yan
AU  - Cui XY
AD  - Department of Biochemistry and Molecular Biology, West China Medical Center of 
      Sichuan University, Chengdu, China.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Curr Ther Res Clin Exp
JT  - Current therapeutic research, clinical and experimental
JID - 0372621
PMC - PMC3969923
OTO - NOTNLM
OT  - Crohn's disease
OT  - cyclooxygenase-2 inhibitor
OT  - inflammatory bowel disease
OT  - meta-analysis
OT  - ulcerative colitis
EDAT- 2008/06/01 00:00
MHDA- 2008/06/01 00:01
PMCR- 2008/06/01
CRDT- 2014/04/03 06:00
PHST- 2008/03/26 00:00 [accepted]
PHST- 2014/04/03 06:00 [entrez]
PHST- 2008/06/01 00:00 [pubmed]
PHST- 2008/06/01 00:01 [medline]
PHST- 2008/06/01 00:00 [pmc-release]
AID - S0011-393X(08)00062-3 [pii]
AID - 10.1016/j.curtheres.2008.06.009 [doi]
PST - ppublish
SO  - Curr Ther Res Clin Exp. 2008 Jun;69(3):181-91. doi: 
      10.1016/j.curtheres.2008.06.009.