Just When You Thought Celebrex Was Finished . . .

The anti-inflammatory selective COX-2 inhibitor drugs – Celebrex and Vioxx – have had their use drastically reduced since their cardiac side effects became widely known 18 months ago. They weren’t really ‘rehabilitated’ when similar (but weaker) effects were found with non-selective NSAIDs like aspirin, Advil, or Aleve.

Now a study reported in BMC Cancer has shown that standard doses of Celebrex taken for 2 years or more were linked to an 83% reduction in the risk of breast cancer. Vioxx, which was still on the market at the time, was linked to a 64% reduction. Lesser reductions were seen with aspirin (51%) and Advil or Aleve (63%).

It seems that a pharmacological property – COX-2 specificity – is responsible for the better results. Before we get too enthused by these findings, however, we must remember that: (1) this was a retrospective cross-sectional analysis (as opposed to a longitudinal, prospective study), and cannot therefore be used as firm evidence of a cause-and-effect; (2) in spite of these and other encouraging results, several clinical trials designed to test the concept further have been stopped, and are unlikely to be re-started.

Hopefully, these results will lead to more effective drug candidates along these lines, but without the shadow of cardiovascular side effects.