A Comparison of Cardiovascular Biomarkers in Patients Treated for Three Months with Etoricoxib, Celecoxib, Ibuprofen, and Placebo
- PMID: 20157362
- PMCID: PMC2817438
- DOI: 10.1111/j.1753-5174.2007.00002.x
A Comparison of Cardiovascular Biomarkers in Patients Treated for Three Months with Etoricoxib, Celecoxib, Ibuprofen, and Placebo
Abstract
OBJECTIVES: Selective cyclooxygenase (COX)-2 inhibitors are effective analgesic and anti-inflammatory agents with improved gastrointestinal safety and tolerability compared with traditional NSAIDs. However, data from long-term, placebo-controlled studies have shown an increased risk of thrombotic cardiovascular (CV) events for COX-2 inhibitors. Changes in levels of CV biomarkers are potentially useful surrogate measures of pathologic changes associated with CV risk. METHODS: We randomized 433 patients with osteoarthritis to etoricoxib 90 mg once daily, celecoxib 200 mg twice daily, ibuprofen 800 mg three times daily, or placebo for 12 weeks. The hypothesis was that etoricoxib would be non-inferior or superior to placebo in effect on C-reactive protein (CRP), LDL-cholesterol, homocysteine, and fibrinogen. RESULTS: Relative to placebo, etoricoxib was noninferior for effect on CRP (decreased 7.8% vs. placebo; 97.5% CI of the difference: -30.5, 22.4), LDL-C (-4.0% vs. placebo; 97.5% CI: -10.6, 3.2), homocysteine (-3.9% vs. placebo; 97.5% CI: -11.6, 4.6), and fibrinogen (-3.7% vs. placebo; 97.5% CI: -9.4, 2.3). Etoricoxib was not different from placebo, celecoxib, or ibuprofen for any biomarker. CONCLUSION: Etoricoxib was comparable to placebo, celecoxib, and ibuprofen for effects on the CV risk markers measured.
Figures


Similar articles
-
Gastrointestinal and cardiovascular risk of non-selective NSAIDs and COX-2 inhibitors in elderly patients with knee osteoarthritis.J Med Assoc Thai. 2009 Dec;92 Suppl 6:S19-26. J Med Assoc Thai. 2009. PMID: 20128070
-
The gastrointestinal safety of the COX-2 selective inhibitor etoricoxib assessed by both endoscopy and analysis of upper gastrointestinal events.Am J Gastroenterol. 2003 Aug;98(8):1725-33. doi: 10.1111/j.1572-0241.2003.07598.x. Am J Gastroenterol. 2003. PMID: 12907325 Clinical Trial.
-
Cardiovascular risk associated with celecoxib or etoricoxib: a meta-analysis of randomized controlled trials which adopted comparison with placebo or naproxen.Minerva Cardioangiol. 2014 Dec;62(6):437-48. Epub 2014 Jul 16. Minerva Cardioangiol. 2014. PMID: 25029569
-
Lessons from 20 years with COX-2 inhibitors: Importance of dose-response considerations and fair play in comparative trials.J Intern Med. 2022 Oct;292(4):557-574. doi: 10.1111/joim.13505. Epub 2022 May 31. J Intern Med. 2022. PMID: 35585779 Review.
-
Clinical use and pharmacological properties of selective COX-2 inhibitors.Eur J Clin Pharmacol. 2008 Mar;64(3):233-52. doi: 10.1007/s00228-007-0400-7. Epub 2007 Nov 13. Eur J Clin Pharmacol. 2008. PMID: 17999057 Review.
Cited by
-
Renal effects of selective cyclooxygenase-2 inhibitor anti-inflammatory drugs: A systematic review and meta-analysis.Explor Res Clin Soc Pharm. 2024 Jul 8;15:100475. doi: 10.1016/j.rcsop.2024.100475. eCollection 2024 Sep. Explor Res Clin Soc Pharm. 2024. PMID: 39114538 Free PMC article. Review.
-
Etoricoxib: a review of its use in the symptomatic treatment of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis and acute gouty arthritis.Drugs. 2009 Jul 30;69(11):1513-32. doi: 10.2165/00003495-200969110-00008. Drugs. 2009. PMID: 19634927 Review.
-
Impact of NSAIDs corticosteroids DMARDs biologics and their comparisons with natural products in C-reactive proteins (CRP) linked cardiovascular disorders.Inflammopharmacology. 2025 May;33(5):2537-2563. doi: 10.1007/s10787-025-01767-1. Epub 2025 May 4. Inflammopharmacology. 2025. PMID: 40319427 Review.
-
Cardiovascular safety of celecoxib in rheumatoid arthritis and osteoarthritis patients: A systematic review and meta-analysis.PLoS One. 2021 Dec 21;16(12):e0261239. doi: 10.1371/journal.pone.0261239. eCollection 2021. PLoS One. 2021. PMID: 34932581 Free PMC article.
-
Safety of Cyclooxygenase-2 Inhibitors in Osteoarthritis: Outcomes of a Systematic Review and Meta-Analysis.Drugs Aging. 2019 Apr;36(Suppl 1):25-44. doi: 10.1007/s40266-019-00664-x. Drugs Aging. 2019. PMID: 31073922 Free PMC article.
References
-
- Bresalier RS, Sandler RS, Quan H, et al. Cardiovascular events associated with rofecoxib in a colorectal adenoma chemoprevention trial. N Engl J Med. 2005;352:1092–102. - PubMed
-
- Solomon SD, McMurray JJ, Pfeffer MA, et al. Cardiovascular risk associated with celecoxib in a clinical trial for colorectal adenoma prevention. N Engl J Med. 2005;352:1071–80. - PubMed
-
- FitzGerald GA. Coxibs Cardiovascular Disease. N Engl J Med. 2004;351:2875–8. - PubMed
LinkOut - more resources
Full Text Sources
Molecular Biology Databases
Research Materials
Miscellaneous