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Celecoxib use may induce liver injury

27 Jan 2018

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.

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Most Read Articles
17 Apr 2019
The ketogenic and Modified Atkin’s diets are effective treatments for children with refractory epilepsy of genetic aetiology, a new study suggests.
Pearl Toh, 17 Apr 2019
A contraceptive vaginal system (Annovera) releasing a combination of segesterone acetate and ethinyl estradiol (SA/EE) effectively inhibits ovulation up to a year even at low systemic levels of SA, reports a review study presented at ENDO 2019.
17 Apr 2019
Non-alcoholic fatty liver disease (NAFLD) – a clinicopathological spectrum comprising hepatic steatosis or non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH) – is the hepatic manifestation of metabolic syndrome recognized as a leading cause of liver morbidity and mortality. Dr Loo Wai Mun, Consultant at the Division of Gastroenterology and Hepatology, National University Hospital, Singapore, speaks with Audrey Abella to discuss how NAFLD can be best managed in primary care.
Jairia Dela Cruz, 2 days ago
Rupatadine at either 10 or 20 mg delivers superior improvements in nasal and ocular symptoms of seasonal allergic rhinitis compared with placebo, with both doses well tolerated by adult and adolescent patients, according to the results of a phase III trial.