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Celecoxib, a selective cyclooxygenase‐2 inhibitor, reduces level of a bone resorption marker in postmenopausal women with rheumatoid arthritis
Author(s) -
Tsuji Shigeyoshi,
Tomita Tetsuya,
Nakase Takanobu,
Hamada Masayuki,
Kawai Hideo,
Yoshikawa Hideki
Publication year - 2014
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12076
Subject(s) - medicine , bone resorption , celecoxib , bone remodeling , endocrinology , rheumatoid arthritis , n terminal telopeptide , bisphosphonate , type i collagen , osteoporosis , cyclooxygenase , alkaline phosphatase , osteocalcin , chemistry , biochemistry , enzyme
Aim Celecoxib ( CEL ), a selective cyclooxygenase‐2 ( COX ‐2) inhibitor, has been reported to suppress osteoclastogenesis in vitro , reduce levels of bone resorption markers in ovariectomized ( OVX ) mice, and prevent bone destruction in rheumatoid arthritis ( RA ) model mice; however, no clinical data has been reported. Here, we prospectively evaluated the changes in bone turnover markers in RA patients who switched from nonsteroidal anti‐inflammatory drugs ( NSAID s) to CEL , to examine the effects of selective COX ‐2 inhibitor on bone metabolism. Methods RA patients who had been treated with NSAID s for more than 12 weeks were switched to CEL (400 mg/day) without any other changes in previously prescribed medications. Urinary type I collagen cross‐linked N‐telopeptide (u NTX ), serum bone alkaline phosphatase ( BAP ), C‐reactive protein ( CRP ), erythrocyte sedimentation rate ( ESR ) and matrix metalloproteinase‐3 ( MMP ‐3) were evaluated before switching to CEL and 16 weeks later. Results Significant reductions in u NTX , a bone resorption marker, were observed in 60 female patients ( P = 0.042), especially in 52 postmenopausal women ( P = 0.033). However, u NTX level did not significantly change in premenopausal women or in men. There were no significant changes in BAP , a bone formation marker. CRP significantly decreased ( P = 0.007), while ESR and MMP ‐3 were unchanged. Conclusion CEL reduced the levels of a bone resorption marker in postmenopausal RA patients, suggesting that this drug may attenuate the accelerated osteoclastic bone resorption associated with menopause.