Celecoxib use may induce liver injury
There is an over-representation of women in published reports of celecoxib drug-induced liver injury (DILI), according to a recent study. Latency has been shown to be short (<3 months) in most patients, but some of them may present with DILI after prolonged use of celecoxib.
“Although rare, celecoxib DILI can have potentially life-threatening consequences,” researchers said.
Eighteen patients (median age 54 years; range, 29‒84; 88 percent female) presented with celecoxib DILI. The median daily dose was 200 mg (range, 200‒533), and median duration and latency were 13 days (1‒730) and 17 days (2‒730), respectively.
DILI was reported in 15 patients (83 percent) after relatively short treatment duration (median 12 days; 1‒42). These patients presented with rash and immunoallergic features, with peripheral or histologic findings of eosinophilia in six (40 percent). In three patients, DILI occurred following prolonged use of celecoxib (range, 152‒730 days), with no immunoallergic features observed.
Liver injury included the following: hepatocellular (n=6), mixed (n=5) and cholestatic (n=4); three patients had an unknown pattern. Clinical outcomes included liver transplantation in two patients (11 percent), chronic liver injury in four (22 percent) and recovery in 12 (67 percent).
Researchers performed a literature search from 2000‒2016 using common terms for liver injury cross-referenced with celecoxib to characterize and examine the salient features of published cases of celecoxib DILI. They analysed identified cases with respect to reported demographic and clinical data.
A commonly prescribed nonsteroidal anti-inflammatory drug, celecoxib has been associated with rare instances of idiosyncratic DILI, according to researchers.