A study has found that treating chronic kidney disease (CKD) patients with specific inhibitors such as Arcoxia, Celebrex, Vioxx, and Prexige could induce renal function alterations and electrolyte deregulation.
These results indicate that the use of selective cyclo-oxygenase-2 (sCOX-2) inhibitors in CKD patients should be closely monitored and long-term use should be avoided.
Commonly used as anti-inflammatory and analgesic drugs, nonselective and selective COX-2 inhibitors are found to be less damaging to the digestive tract compared to other non-steroidal anti-inflammatory drugs (NSAIDs), making them attractive therapeutic tools.
However, some adverse effects due to the use of sCOX-2 inhibitors were described, such as acute kidney injury, glomerular disease, and cardiovascular events in patients with normal renal function. So far, no study was able to produce conclusive results on this matter, making the relationship between CKD development and sCOX-2 inhibitors unclear.
The study, “Selective cyclooxygenase-2 inhibitor use and progression of renal function in patients with chronic kidney disease: a single-center retrospective cohort study,” was published in the International Journal of Nephrology and Renovascular Disease.
Researchers aimed to clarify the relationship between sCOX-2 inhibitors and renal progression among CKD patients in short- and long-term treatments.
A total of 184 CKD diagnosed patients were enrolled, of which 92 were administrated with sCOX-2 inhibitors for chronic pain or chronic bone and joint disease treatment. The remaining 92 patients enrolled in the study were included in the control group.
The authors of the study reported that the patients undergoing treatment with sCOX-2 inhibitors presented a decline in their renal function, evaluated by the estimated glomerular filtration rate (eGFR), compared to the control group. This effect was observed at three and six months of follow-up, and continued even after one and two years after the patients discontinued sCOX-2 treatment.
The sCOX-2 inhibitor group also had electrolyte deregulation during drug use, presenting increased potassium in the blood, further confirming the renal dysfunction.
This study demonstrated that CKD patients who do require sCOX-2 inhibitor treatment should be closely monitored. Otherwise their condition could worsen, with increasing potassium levels in their blood occurring in early treatment and in the long term, even after treatment with sCOX-2 inhibitors has been stopped.
“It can be implied from these results that sCOX-2 inhibitor avoidance for more than 3 months is imperative to delay renal function deterioration among CKD patients,” the authors wrote.