Celecoxib and Etoricoxib may reduce risk of ischemic stroke in patients with rheumatoid arthritis: A nationwide retrospective cohort study.
Celecoxib-compound CID: 2662
Etoricoxib (CID: 123619)
ischemic stroke (IS)
non-steroidal anti-inflammatory drugs (NSAIDs)
rheumatoid arthritis
risk
Journal
Frontiers in neurology
ISSN: 1664-2295
Titre abrégé: Front Neurol
Pays: Switzerland
ID NLM: 101546899
Informations de publication
Date de publication:
2022
2022
Historique:
received:
17
08
2022
accepted:
06
10
2022
entrez:
7
11
2022
pubmed:
8
11
2022
medline:
8
11
2022
Statut:
epublish
Résumé
Previous studies reported conflicting results about the risk of ischemic stroke associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs) in patients with rheumatoid arthritis (RA). We aimed to investigate two specific COX-2 inhibitors, Celecoxib and Etoricoxib, and their corresponding effects on the risk of ischemic stroke in patients with RA. 10,857 patients newly diagnosed with RA were identified and sampled from the Taiwanese National Health Insurance Research Database during the period from 2001 to 2009. The identification of RA was based on the criteria of ICD-9-CM diagnosis code 714.0. Patients diagnosed with cerebrovascular disease and those receiving RA treatment prior to the first diagnosis of RA were excluded. Study endpoint was ischemic stroke, defined by ICD-9-CM code. Cox proportional hazard models and Kaplan Meier curves were used to reveal covariates and differences by drugs in the risk of ischemic stroke. Dosages for Celecoxib were defined as ≤ 200 and >200 mg/day; those for Etoricoxib were 0 and >0 mg/day. Among 7,904 RA patients, 6,669 did not take Celecoxib and 564 (8.46%) of them experienced an ischemic stroke event. Of the 597 individuals who took ≤ 200 mg/day of Celecoxib, 58 (9.72%) had strokes. Of the 638 patients who took >200 mg/day of Celecoxib, 38 (5.96%) eventually experienced a stroke. Among the 7,681 patients who did not take Etoricoxib, 654 (8.51%) experienced an ischemic stroke, while 6 (2.69%) in 223 patients who consumed Etoricoxib had a stroke event. Consuming more than 200 mg of Celecoxib per day for <3.5 years lowered the incidence rate for strokes [hazard ratio (HR) 0.67, 95% Confidence Interval (CI) 0.48-0.93 for dosage and HR 0.22, 95% CI 0.10-0.46 for duration, both This population-based retrospective cohort study has shown that Celecoxib and Etoricoxib reduce the risk of ischemic stroke in patients with RA in a dose- and time-dependent manner.
Sections du résumé
Background and purpose
UNASSIGNED
Previous studies reported conflicting results about the risk of ischemic stroke associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs) in patients with rheumatoid arthritis (RA). We aimed to investigate two specific COX-2 inhibitors, Celecoxib and Etoricoxib, and their corresponding effects on the risk of ischemic stroke in patients with RA.
Patients and methods
UNASSIGNED
10,857 patients newly diagnosed with RA were identified and sampled from the Taiwanese National Health Insurance Research Database during the period from 2001 to 2009. The identification of RA was based on the criteria of ICD-9-CM diagnosis code 714.0. Patients diagnosed with cerebrovascular disease and those receiving RA treatment prior to the first diagnosis of RA were excluded. Study endpoint was ischemic stroke, defined by ICD-9-CM code. Cox proportional hazard models and Kaplan Meier curves were used to reveal covariates and differences by drugs in the risk of ischemic stroke. Dosages for Celecoxib were defined as ≤ 200 and >200 mg/day; those for Etoricoxib were 0 and >0 mg/day.
Results
UNASSIGNED
Among 7,904 RA patients, 6,669 did not take Celecoxib and 564 (8.46%) of them experienced an ischemic stroke event. Of the 597 individuals who took ≤ 200 mg/day of Celecoxib, 58 (9.72%) had strokes. Of the 638 patients who took >200 mg/day of Celecoxib, 38 (5.96%) eventually experienced a stroke. Among the 7,681 patients who did not take Etoricoxib, 654 (8.51%) experienced an ischemic stroke, while 6 (2.69%) in 223 patients who consumed Etoricoxib had a stroke event. Consuming more than 200 mg of Celecoxib per day for <3.5 years lowered the incidence rate for strokes [hazard ratio (HR) 0.67, 95% Confidence Interval (CI) 0.48-0.93 for dosage and HR 0.22, 95% CI 0.10-0.46 for duration, both
Conclusion
UNASSIGNED
This population-based retrospective cohort study has shown that Celecoxib and Etoricoxib reduce the risk of ischemic stroke in patients with RA in a dose- and time-dependent manner.
Identifiants
pubmed: 36341096
doi: 10.3389/fneur.2022.1018521
pmc: PMC9630581
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1018521Informations de copyright
Copyright © 2022 Chen, Lee, Perng, Chiou, Wang, Lin, Wei and Tsou.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Ann Rheum Dis. 2019 Dec;78(12):1734-1736
pubmed: 31413002
BMC Musculoskelet Disord. 2010 Oct 25;11:246
pubmed: 20973952
Int J Rheum Dis. 2019 Aug;22(8):1410-1418
pubmed: 31050219
Int J Rheum Dis. 2018 Aug;21(8):1591-1599
pubmed: 29372595
Neural Regen Res. 2019 Mar;14(3):450-451
pubmed: 30539812
Am J Cardiol. 2007 Jan 1;99(1):91-8
pubmed: 17196469
Int J Rheum Dis. 2022 Aug;25(8):827-843
pubmed: 35754354
Psychol Methods. 2010 Sep;15(3):250-67
pubmed: 20822251
Vasc Health Risk Manag. 2014;10:25-32
pubmed: 24421643
Pharm Stat. 2021 Jan;20(1):15-24
pubmed: 32776719
J Clin Pharm Ther. 2017 Feb;42(1):27-38
pubmed: 28019014
RSC Adv. 2021 Feb 10;11(13):7129-7137
pubmed: 35423287
Pharmacogenet Genomics. 2012 Apr;22(4):310-8
pubmed: 22336956
Int J Rheum Dis. 2022 Jun;25(6):669-677
pubmed: 35429115
Curr Med Res Opin. 2019 Feb;35(2):313-320
pubmed: 29939099
Epidemiology. 2010 Jan;21(1):13-5
pubmed: 20010207
Curr Pharm Des. 2004;10(6):589-601
pubmed: 14965322
PLoS One. 2018 Nov 1;13(11):e0204746
pubmed: 30383755
Ther Adv Drug Saf. 2017 Jun;8(6):173-182
pubmed: 28607667
Arthritis Res Ther. 2013;15 Suppl 3:S2
pubmed: 24267197
Int J Environ Res Public Health. 2018 Jun 07;15(6):
pubmed: 29875338
Stat Med. 2017 Jul 10;36(15):2347-2362
pubmed: 28276080
Drug Saf. 2020 Apr;43(4):301-318
pubmed: 31916080
Arterioscler Thromb Vasc Biol. 2011 May;31(5):986-1000
pubmed: 21508345
Front Cell Neurosci. 2021 Sep 24;15:739506
pubmed: 34630043
Curr Med Chem. 2019;26(18):3225-3241
pubmed: 29756563
Molecules. 2021 Jun 28;26(13):
pubmed: 34203324
West J Med. 2001 Oct;175(4):267-8
pubmed: 11577061
N Engl J Med. 2018 Dec 20;379(25):2429-2437
pubmed: 30575491
Int J Rheum Dis. 2013 Feb;16(1):24-9
pubmed: 23441769
Hypertension. 1992 Aug;20(2):253-63
pubmed: 1639468
PLoS One. 2017 Jun 28;12(6):e0179081
pubmed: 28658301
Drugs Aging. 2019 Apr;36(Suppl 1):25-44
pubmed: 31073922
Fundam Clin Pharmacol. 2019 Oct;33(5):589-600
pubmed: 30860620
Eur J Clin Pharmacol. 2010 Jun;66(6):619-25
pubmed: 20157701
Int J Rheum Dis. 2022 Jun;25(6):699-704
pubmed: 35505588
Stroke. 2006 Jul;37(7):1725-30
pubmed: 16728684
Circulation. 2018 Mar 20;137(12):e67-e492
pubmed: 29386200
Med J Aust. 2011 Nov 7;195(9):525-9
pubmed: 22060087
N Engl J Med. 2005 Mar 17;352(11):1071-80
pubmed: 15713944
J Formos Med Assoc. 2021 Mar;120(3):926-938
pubmed: 33012636
Int J Mol Sci. 2019 Aug 30;20(17):
pubmed: 31480335
Front Pharmacol. 2022 Feb 09;13:818877
pubmed: 35222032
Biomed Pharmacother. 2018 Dec;108:1804-1808
pubmed: 30372885
Front Cardiovasc Med. 2022 Feb 03;8:812631
pubmed: 35187113
Biochem Pharmacol. 2020 Oct;180:114147
pubmed: 32653589
Open Rheumatol J. 2012;6:6-20
pubmed: 22582102
Hypertension. 2004 Aug;44(2):140-5
pubmed: 15226279
N Engl J Med. 2006 Aug 31;355(9):885-95
pubmed: 16943401
N Engl J Med. 2005 Mar 17;352(11):1092-102
pubmed: 15713943
PLoS One. 2018 Sep 19;13(9):e0203362
pubmed: 30231067
BMJ. 2011 Jan 11;342:c7086
pubmed: 21224324