Not so fast with the celebrations over Celebrex

Published in the American Journal of Gastroenterology, a new study led by Dr. Nadir Arber of Tel Aviv University found that people taking Pfizer’s anti-inflammatory pain pill Celebrex (celecoxib) were less likely to develop polyps in their colon, but they did experience a higher risk of cardiovascular problems.

More than half of the 1,516 patients with a history of colorectal cancer involved in the study received Celebrex for about three years, after which point the study was halted due to concerns about increased cardiovascular risk. Nevertheless, some patients remained on the drug for five years. Those who completed the five year course had a 66 percent higher risk of serious cardiac disorders, but their likelihood of developing new or advanced polyps dropped to 51 percent, a very small difference when compared to 58 percent in the placebo group.

Worse, during the fifth year of the study alone — two years after the drug trial had officially ended and the medication stopped — the patients who had been treated with Celebrex actually developed new polyps at a higher rate (27 percent) than those who never took the drug at all (16 percent).

Still, the results are “very promising,” Dr. Arber told Reuters Health.

ACSH’s Dr. Josh Bloom, however, doesn’t buy it. “If this is ‘promising,’ I’d hate to see what ‘disappointing’ looks like. In order to get a marginal reduction in polyps, you have to be willing to accept a substantially higher cardiovascular risk,” he notes. “This risk alone makes this a dubious treatment option, but to then have the polyps grow back even faster following cessation of the drug is bizarre and troubling.”

ACSH's Dr. Gilbert Ross is strongly in agreement with Dr. Arber’s advice that a patient who is considering the drug should first and foremost require a conversation with their physician. He notes that, “People with a strong family history of colorectal cancer, and especially those with familial polyp syndrome or inflammatory bowel disease, are among those who might be on the benefit side of this equation, especially if their cardiovascular risk is low.”