Continuous Treatment with Certain NSAIDs Should Be Avoided in Kidney Disease Patients, Study Suggests

Continuous Treatment with Certain NSAIDs Should Be Avoided in Kidney Disease Patients, Study Suggests

Continuous treatment with nonsteroidal anti-inflammatory drugs Celebrex (celecoxib) and etoricoxib for three to six months increases the rate of kidney function decline in chronic kidney disease (CKD) patients both in the short and long term, according to a study published in the International Journal of Nephrology and Renovascular Disease.

Etoricoxib, Merck’s selective COX-2 inhibitor, has not yet been approved for use in the United States, although it used in many other countries.

The authors of the study, “Selective cyclooxygenase-2 inhibitor use and progression of renal function in patients with chronic kidney disease: a single-center retrospective cohort study,” suggest that treatment with the drugs for more than three months should be avoided to delay the worsening of kidney function in CKD patients.

To determine the progression of kidney function and electrolyte abnormalities in CKD patients following the use of the drugs, the team of researchers led by Dr. Bancha Satirapoj of the Department of Medicine at Phramongkutklao Hospital and College of Medicine in Bangkok, Thailand, analyzed data obtained from 92 CKD patients who were treated with Celebrex and etoricoxib and 92 patients who were not treated with the drugs.

The researchers analyzed the medical data, estimated glomerular filtration rate (a test measuring kidney function), and serum electrolytes of the patients at three and six months from January 2009 to January 2014. They followed the patients until they stopped taking the drugs one and two years later.

The results showed that kidney function declined more in patients who were treated with the drugs compared to patients who were not treated at three and six months follow-up. The decline was also observed at one and two years after the patients stopped using the drugs.

In addition, patients treated with the drugs had significantly higher levels of potassium in their blood compared to those who were not treated with the drugs.

The authors concluded that Celebrex and etoricoxib are associated with an increased risk for rapid decline in kidney function and elevated potassium levels in the blood, both in the short and long term. The use of the drugs “should be closely monitored and chronic exposure to any sCOX-2 inhibitors should be avoided,” they wrote.

Celebrex and etoricoxib are selective non-steroidal anti-inflammatory drugs that are widely used to treat digestive tract diseases such as stomach ulcers. They act by preserving the gut lining, providing epithelial integrity, and maintaining platelet function.

Previous work has shown they may cause adverse side effects such as acute kidney injury, glomerular disease, tubulointerstitial disease, fluid electrolytes imbalance, and cardiovascular disease in people with normal kidney function. This is the first study that assessed the short and long-term effects of the drugs in CKD patients.

Özge has a MSc. in Molecular Genetics from the University of Leicester and a PhD in Developmental Biology from Queen Mary University of London. She worked as a Post-doctoral Research Associate at the University of Leicester for six years in the field of Behavioural Neurology before moving into science communication. She worked as the Research Communication Officer at a London based charity for almost two years.

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