Good news for AI users with joint pain

ChiSandy

Renowned Cleveland Clinic cardiologist Steven Nissen reported the results of a study today that upended the prevailing wisdom about the COX-2 inhibitor NSAID celecoxib (aka Celebrex) being more cardiotoxic than the conventional NSAIDs naproxen (Aleve) and ibuprofen (Advil, Motrin).

Celecoxib dangers were overstated

Turns out that not only were there far fewer gastrointestinal incidents with celecoxib, celecoxib users suffered fewer cardiovascular events than conventional NSAID users. COX-2 inhibitors, primarily Celebrex (but also Bextra & Vioxx), were hailed when introduced as being easier on the gut than conventional NSAIDs and as effective for treating inflammation, osteoarthritis and dysmenorrhea. But a few years later, some studies pointed to a higher incidence of cardiac events among users of Vioxx, so it was pulled off the market along with Bextra. Celebrex remained available, but less widely prescribed—a last resort non-opioid painkiller for those in danger of GI bleeds from conventional NSAIDs. When I had my first knee replacement surgery in 2012 and mentioned I had GERD, my peri-op physician told me that as soon as the first adverse news about Vioxx came out, she bought 2000 of them to hoard in advance of its becoming unavailable. She suggested I ask for Celebrex. I filed it away for future reference, but in 2013 when I developed a “gastric erosive lesion of probable chemical origin," and my GERD became worse, the GI doc told me I could never again take an Aleve or an Advil, unless I wanted a full-blown ulcer & even erosive esophagitis (which can be precancerous). He suggested that after my upcoming second knee replacement, once weaned off opioids & gabapentin I strongly consider asking for celecoxib. I didn't at first, but after I tore the head of my gastrocnemius muscle while hiking in the Rockies, my orthopod prescribed it. Worked like a charm, and didn't affect my gut.

So there’s a safe and potent item in the arsenal to ease AI-caused-or-enhanced joint pain. No wonder I have had such mild SEs on letrozole—I’ve popped 200mg of celecoxib every morning ever since that gastroc tear (and bursitis from a gluteal tear suffered when shoveling and slogging through 2+ ft. of snow back in 2015).

Anonymous

Nice info ChiSandy. Thanks. My husband is a user of Celebrex for his chronic back pain