celecoxib, Celebrex
Celecoxib in osteoarthritis and rheumatoid arthritis: new preparation. As disappointing as rofecoxib.

[No authors listed]

(1) The reference treatment for drug-based symptomatic relief of osteoarthritis and rheumatoid arthritis is paracetamol and low-dose ibuprofen. (2) The clinical file on celecoxib, a drug promoted as a selective COX-2 inhibitor, is bulky but fails to answer several practical questions, mainly because it lacks comparative trials against paracetamol and low-dose NSAIDs. (3) In osteoarthritis, three double-blind trials versus naproxen and placebo in a total of 3 258 patients show that the analgesic effect of celecoxib 200 mg/day is moderate and does not differ significantly from that of naproxen. Giving celecoxib in one or two daily doses makes no difference in terms of efficacy. (4) In rheumatoid arthritis, two double-blind trials against naproxen and placebo in a total of 2252 patients, and a double-blind trial versus sustained-release diclofenac, show that the symptomatic effect of celecoxib is moderate and no different from that of the comparator NSAIDs. (5) There is no evidence that the safety profile of celecoxib is very different from that of other NSAIDs. The advantage in terms of gastrointestinal adverse effects appears very slight. According to clinical trials and pharmacovigilance data, celecoxib is in no way exempt from the severe gastrointestinal adverse effects generally associated with NSAIDs. (6) In short, celecoxib changes nothing in the management of osteoarthritis and rheumatoid arthritis.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11718158&dopt=Abstract celecoxib, Celebrex



celecoxib, Celebrex
Effects of selective COX-1 and -2 inhibition on formalin-evoked nociceptive behaviour and prostaglandin E(2) release in the spinal cord.

Tegeder I, Niederberger E, Vetter G, Brautigam L, Geisslinger G.

pharmazentrum frankfurt, Klinikum der Johann Wolfgang Goethe-Universitat, Frankfurt am Main, Germany.

Nociception evoked prostaglandin (PG) release in the spinal cord considerably contributes to the induction of hyperalgesia and allodynia. To evaluate the relative contribution of cyclooxygenase-1 (COX-1) and COX-2 in this process we assessed the effects of the selective COX-1 inhibitor SC560 and the selective COX-2 inhibitor celecoxib on formalin-evoked nociceptive behaviour and spinal PGE(2) release. SC560 (10 and 20 mg/kg) significantly reduced the nociceptive response and completely abolished the formalin-evoked PGE(2) raise. In contrast, celecoxib (10 and 20 mg/kg) was ineffective in both regards, i.e. the flinching behaviour was largely unaltered and the formalin-induced PGE(2) raise as assessed using microdialysis was only slightly, not significantly reduced. This suggests that the formalin-evoked rapid PG release was primarily caused by COX-1 and was independent of COX-2. Mean free spinal cord concentrations of celecoxib during the formalin assay were 32.0 +/- 4.5 nM, thus considerably higher than the reported IC50 for COX-2 (3-7 nM). Therefore, the lack of efficacy of celecoxib is most likely not to be a result of poor tissue distribution. COX-2 mRNA and protein expression in the spinal cord were not affected by microdialysis alone but the mRNA rapidly increased following formalin injection and reached a maximum at 2 h. COX-2 protein was unaltered up to 4 h after formalin injection. The time course of COX-2 up-regulation suggests that the formalin-induced nociceptive response precedes COX-2 protein de novo synthesis and may therefore be unresponsive to COX-2 inhibition. Considering the results obtained with the formalin model it may be hypothesized that the efficacy of celecoxib in early injury evoked pain may be less than that of unselective NSAIDs.

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celecoxib, Celebrex
Stimulated release of arachidonic acid by agonists of the peroxisome proliferator-activated receptor and retinoic acid receptors.

Levine L.

Department of Biochemistry, Brandeis University, Waltham, MA 02454, USA. llevine brandeis.edu

Release of arachidonic acid from rat liver cells is stimulated after a 6-hour incubation with 9-cis retinoic acid, all trans retinoic acid, the selective peroxisome proliferator-activated receptor-gamma synthetic thiazolidinedione, ciglitazone, the cyclopentenones, 15-deoxy-Delta(12,14) PGJ2 and PGA1 and the non-steroidal anti-inflammatory drugs, celecoxib and indomethacin. The rates of the release stimulated by 15-deoxy-Delta(12,14) PGJ2 differ from those observed with celecoxib. Arachidonic acid release by9-cis retinoic acid in the presence of either ciglitazone or trans retinoic acid is synergistic. It is additive in the presence of celecoxib. Cycloheximide and actinomycin inhibit the release of arachidonic acid stimulated by 15-deoxy-Delta(12,14) PGJ2 but not by celecoxib. The findings indicate that agonists of the peroxisome proliferator-activated receptor-gamma and retinoic acid receptors stimulate the release of arachidonic acid. The mechanisms involved may differ in the cases of 15-deoxy-Delta(12,14) PGJ2 and celecoxib. Copyright 2001 Harcourt Publishers Ltd.

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celecoxib, Celebrex
Effects of NSAIDs on cryoprobe-induced gastric ulcer healing in rats.

Tibble J, Sigthorsson G, Caldwell C, Palmer RH, Bjarnason I.

Department of Medicine, Guy's, King's and St Thomas' Medical School, London, UK.

BACKGROUND: Failure of ulcer healing may be critically important to the development of serious gastrointestinal complications in patients on long-term NSAIDs. AIM: To determine the effect of indometacin, celecoxib, a cyclooxygenase-2-specific inhibitor, and nabumetone, a pro-drug, on ulcer healing rates in the rat. METHODS: Gastric ulcers were induced using a cryoprobe. An NSAID or a vehicle control was administered to groups of eight rats for 3 or 6 days (2 mg/kg indometacin, 9 mg/kg celecoxib or 40 mg/kg nabumetone). The ulcer area was measured and epithelial proliferation at the ulcer margins was measured histochemically. The effect of the drugs on intestinal prostaglandin levels was also assessed. RESULTS: The mean ulcer sizes in the four groups on day 3 were comparable. On day 6, control animals and those receiving nabumetone showed significant ulcer healing (P < 0.02), while the mean ulcer sizes in the indometacin (P < 0.01) and celecoxib (P < 0.02) groups were significantly larger than those in the control group. Higher doses of nabumetone (160 mg/kg), however, impaired healing. Intestinal prostaglandins were reduced (P < 0.01) only in indometacin-treated animals. The epithelial proliferation index was significantly lower among indometacin- (P=0.02) and celecoxib-treated (P=0.03) animals compared to controls at day 3. CONCLUSIONS: Celecoxib and indometacin both decreased the epithelial proliferative response and delayed healing of cryoprobe-induced gastric ulcers. In contrast, nabumetone impaired ulcer healing only at very high doses.

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celecoxib, Celebrex
Chemopreventive properties of a selective inducible nitric oxide synthase inhibitor in colon carcinogenesis, administered alone or in combination with celecoxib, a selective cyclooxygenase-2 inhibitor.

Rao CV, Indranie C, Simi B, Manning PT, Connor JR, Reddy BS.

Chemoprevention Program, American Health Foundation, Valhalla, New York 10595, USA. crao ahf.org

The inducible isoforms of nitric oxide synthase (iNOS) and cyclooxygenase (COX-2) are overexpressed in colonic tumors of humans, as well as in colon tumors that develop in rats after the administration of the colon-specific carcinogen, azoxymethane (AOM). iNOS may regulate COX-2 production of proinflammatory prostaglandins, which are known to play a key role in colon tumor development. Experiments were designed to assess the potential chemopreventive properties of highly selective iNOS inhibitors, administered individually and in combination with a selective COX-2 inhibitor, on the development of AOM-induced colonic aberrant crypt foci (ACF). F344 rats were fed experimental diets containing one of the following: 0, 10, 30, or 100 parts/million (ppm) of the selective iNOS inhibitor L-N(6)-(1-iminoethyl)lysine tetrazole-amide (SC-51); 1800 ppm of the less potent, selective iNOS inhibitor aminoguanidine (AG); 500 ppm of the COX-2 inhibitor celecoxib; 320 ppm of the nonsteroidal anti-inflammatory sulindac (positive control); or 30 ppm of SC-51 with 500 ppm of celecoxib, and 100 ppm of SC-51 with 500 ppm of celecoxib. One and 2 weeks later, rats received s.c. injections of AOM at a dose of 15 mg/kg of body weight. At 17 weeks of age, all rats were sacrificed. Colons were evaluated for ACF, and colonic mucosae were assayed for COX and NOS isoform enzyme activities. Samples of venous blood, collected at various time points, were analyzed for these agents. SC-51, administered alone, demonstrated dose-dependent inhibition of the incidence of colonic ACF. The highest doses of SC-51 (100 ppm) and AG (1800 ppm) significantly suppressed the incidence of colonic ACF (P < 0.01 and < 0.001, respectively) and crypt multiplicity in terms of numbers of aberrant crypts/focus (P < 0.0001). Importantly, the combination of either low or high effective doses of SC-51 (30 or 100 ppm) and celecoxib (500 ppm) suppressed AOM-induced colonic ACF formation (P < 0.05 and < 0.001, respectively) and reduced multiplicity of four or more aberrant crypts/focus (P < 0.0001) to a greater extent than did these agents administered individually. As expected, sulindac inhibited colonic ACF formation (P < 0.001) and reduced the multiplicity of four or more aberrant crypts (P < 0.0001) to approximately 45%. The enzymatic activities of COX-2 and iNOS were significantly induced in the AOM-treated animals, and administration of the iNOS inhibitors, SC-51 and AG, significantly inhibited the activities of both iNOS and COX-2 in the colonic mucosa. The combined administration of SC-51 and celecoxib inhibited the COX-2 activity to a greater extent than did either of these agents administered alone. These findings support the hypothesis that selective iNOS inhibitors may have chemopreventive properties and that coadministration with a selective COX-2 inhibitor may have additional chemopreventive potential.

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celecoxib, Celebrex
A cross-media content analysis of motivational themes in direct-to-consumer prescription drug advertising.

Sumpradit N, Ascione FJ, Bagozzi RP.

Department of Social and Administrative Sciences, College of Pharmacy, University of Michigan, Ann Arbor, Michigan 48105, USA.

BACKGROUND: Direct-to-consumer (DTC) advertising of prescription drugs is a widely discussed issue in health care. However, little is known about the characteristics of the motivational themes used in this type of advertising. OBJECTIVES: The aim of this study was to investigate the concurrent presentation of motivational themes in DTC print and television advertisements. METHODS: The content analyses focused on advertisements of 2 targeted drug classes (cyclooxygenase-2 enzyme inhibitors and 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) in magazines and on television. Targeted print advertisements (for celecoxib, rofecoxib, atorvastatin, pravastatin, and simvastatin) from September to December 2001 and targeted television advertisements (for celecoxib, rofecoxib, and simvastatin) from November 2001 were investigated. The motivational themes were assessed using a theoretical framework based on self-regulatory focus theory and cultural orientation. Self-regulatory focus was examined in terms of goal orientation (promotion vs prevention) and emotional aspects, (e.g., cheerfulness, dejection, quiescence, agitation). The cultural orientation was examined in terms of individualism versus collectivism. The visual-verbal match was categorized as direct if the audio and visual information was semantically redundant, as partial if it was partially related, and as no match at all if it was different or conflicting. RESULTS: Twelve print advertisements in 10 magazines and 4 television advertisements on 4 television networks were examined; the interrater reliability scores from 3 independent, trained judges ranged from 0.93 to 0.99. The score was low (0.57) in the visual-verbal match measurement for television advertisements. Products in the same category appeared to be promoted using different self-regulatory foci. For example, celecoxib and atorvastatin advertisements tended to be promotion oriented, whereas pravastatin advertisements tended to be prevention oriented. Motivational themes were found throughout the print advertisements (e.g., pictures, headlines, main text). Only a few advertisements illustrated factual information about a product in a pictorial format. The cultural orientation of the advertisements was similar across brands, with individualistic appeals being common. On television, visual-verbal matches (either direct or partial matches) were generally found, except in the section where risk information was presented. CONCLUSION: In this content analysis, prescription drugs in the same class appeared to be promoted using different self-regulatory foci, but individualistic appeals were found more often than collectivistic appeals across brands.

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celecoxib, Celebrex
Stability-indicating methods for the determination of doxazosin mezylate and celecoxib.

Bebawy LI, Moustafa AA, Abo-Talib NF.

National Organization For Drug Control and Research (NODCAR), 6 Hussen Kamal el Deen, Ben-el-sariat, Dokki, Giza, Egypt. a.c.afri egyptonline.com

Two stability-indicating methods were developed for the determination of doxazosin mesylate (I) and celecoxib (II) in the presence of their degradation products. The first method depends on the use of first derivative spectrophotometry (D(1)) at 256, 269 nm for (I) and (II), respectively. This method determines (I) and (II) in concentration ranges of 0.8-12 and 1-20 microg ml(-1) with mean percentage accuracies of 99.21+/-0.88 and 99.59+/-1.67% for (I) and (II), respectively. The second method depends on the quantitative densitometric evaluation of thin-layer chromatography of (I) and (II) in the presence of their degradation products without any interference. Methylisobutyl ketone-glacial acetic acid-water (20:10:10) was used as a mobile phase for (I) and cyclohexane-dichloromethane-diethyleamine (50:40:10) for (II). The chromatograms were scanned at 248 and 253 nm for (I) and (II), respectively. This method determines (I) and (II) in concentration ranges of l-4 microg per spot for both drugs with mean percentage accuracies of 100.19+/-0.95 and 99.91+/-1.95% for (I) and (II), respectively. The suggested methods were used to determine doxazosin mesylate and celecoxib in bulk powder, laboratory-prepared mixtures and pharmaceutical dosage forms (cardura tablet and celebrex capsule). The results obtained by applying the proposed methods were statistically analysed and compared with those obtained by the reported methods.

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