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Nonsteroidal anti-inflammatory drugs (NSAIDs) and selective cyclooxygenase-2 (COX-2) inhibitors (COXIBs) can reduce the risk of developing colorectal cancer (CRC) and are being considered for use as adjuvant therapy for treatment of CRC patients. However, long-term use of most NSAIDs, except aspirin, increases cardiovascular risk, hampering use of these drugs in CRC prevention and possibly for treatment. CG100649 is a new member of the COXIB family, which is proposed to inhibit both COX-2 and carbonic anhydrase-I/-II (CA-I/-II) activity. Using mouse models, we show here that CG100649 inhibits premalignant and malignant colorectal lesions in mouse models, partly through inhibiting tumor cell proliferation. These pre-clinical findings suggest a need for further exploration of CG100649 for CRC prevention and treatment. The long-term safety profile of CG100649, particularly regarding its effect on cardiovascular risk, is yet to be determined. [ABSTRACT FROM AUTHOR]

Little data exist regarding pediatric celecoxib ingestions. This study described the pattern of pediatric celecoxib ingestions reported to poison control centers. Cases were isolated celecoxib ingestions by patients aged 0-5 years during 2000-2007 reported to Texas poison control centers. The distribution of cases was described with respect to demographic and clinical factors. Of the 177 total patients, dose ingested in milligrams was reported for 92 patients. Mean reported dose was 305.5 mg (range 10-2300 mg). Of those 92 cases, distribution by management site was 89.1% on site, 6.5% already at/en route to healthcare facility and 4.3% referred to healthcare facility. Final medical outcome was no effect for 95.7% cases and minor effect for 4.3% cases. Specific clinical effects reported (in only one case each) were rash, abdominal pain, vomiting, agitation/irritability, and drowsiness. All of the pediatric celecoxib ingestions reported to Texas poison control centers resulted in no or minor effect. [ABSTRACT FROM AUTHOR]

The cyclooxygenase-2 (COX-2) inhibitor rofecoxib was withdrawn from the US market on September 30, 2004, and valdecoxib was withdrawn on April 7, 2005. The impact of these actions on COX-2 inhibitor exposures reported to poison control centers was unknown. The objective of this study was to describe the pattern of COX-2 inhibitor exposures reported to Texas poison control centers before and after rofecoxib and valdecoxib were withdrawn. The number of celecoxib, rofecoxib, and valdecoxib exposures reported to Texas poison control centers each month during 1999-2006 was identified and examined for changes over time. Comparisons were made with respect to those exposures reported immediately prior to withdrawal (October 2003-September 2004) and to exposures after withdrawal (April 2005-December 2006). The mean monthly number of reported exposures prior to withdrawal was 18.8 for celecoxib, 20.3 for rofecoxib, 13.3 for valdecoxib, and 51.5 for total COX-2 inhibitors. The mean monthly number of reported exposures after withdrawal was 9.3 for celecoxib, 1.8 for rofecoxib, 1.3 for valdecoxib, and 12.3 for total COX-2 inhibitors, representing declines of 51, 91, 90, and 76%, respectively. The withdrawal of rofecoxib and valdecoxib from the market resulted in a decrease in the number of COX-2 inhibitor exposures reported to Texas poison control centers. However, rofecoxib and valdecoxib exposures continued to be reported for a long time after withdrawal. Reported celecoxib exposures declined even though it was not withdrawn from the market. [ABSTRACT FROM AUTHOR]

Concerns have been raised about the safety of celecoxib. This study described the pattern of exposures involving only celecoxib (isolated exposures) reported to Texas poison control centers from 1999 to 2004. The mean dose was 701 mg. The patient age distribution was ≤5 years (48%), 6–19 years (8%), and ≥20 years (44%). In 78% of cases, exposure was unintentional. Of the exposures, 74% were managed outside of health care facilities. The final medical outcome was classified as no effect for 82% of the cases, and minor effects for 12% of the cases. Adverse clinical effects were listed for 5% of the patients, the most frequently reported being rash (3%), drowsiness (3%), pruritis (2%), and vomiting (2%). The most frequently listed treatment was decontamination by dilution (43%) or food (32%). The majority of isolated celecoxib exposures could be managed outside of health care facilities, and the outcome was generally favorable. [ABSTRACT FROM AUTHOR]

Background: This study compares the risk of acute myocardial infarction among patients exposed to etodolac, naproxen, celecoxib, and rofecoxib., Methods: A retrospective cohort study in 38 258 veteran patients (26 376 patient-years) measured the adjusted odds ratios of acute myocardial infarction during exposure to etodolac, naproxen, celecoxib, or rofecoxib., Results: Diagnosis of acute myocardial infarction was confirmed in 100 patients who were exposed to a study nonsteroidal anti-inflammatory drug. Compared to naproxen, the increased risk of acute myocardial infarction was not significant for etodolac (OR = 1.32, P = .27), whereas celecoxib (OR = 2.18, 95% CI 1.09-4.35, P = .03) and rofecoxib (OR = 2.16, 95 CI 1.04-4.46, P = .04) were significant. A post hoc analysis indicates that patients with a prior history of acute myocardial infarction had a significant, 4.26-fold risk for another acute myocardial infarction if taking celecoxib or rofecoxib., Conclusion: Etodolac is not associated with a statistically increased risk of acute myocardial infarction compared to naproxen.