Abstract
Celecoxib is a potent anti-inflammatory drug with a safety profile that has been well-demonstrated
in several human diseases and is reported to have beneficial effects in a rat model
of intracerebral hemorrhage (ICH). We investigated the efficacy and safety of celecoxib
treatment in patients with primary ICH. We retrospectively collected clinical data
of patients admitted within 48 h after the onset of primary ICH. We classified the
patients administered celecoxib (400 mg/day) for ≥7 days as the celecoxib-treated group (n=17) and classified the patients who were not administered celecoxib as the control
group (n=17). The volumes of hematoma and edema were analyzed with initial and follow-up (at
approximately 7 days) brain CT scans. Baseline characteristics, initial severity of
neurologic sequelae, and initial volumes of the lesions were not different between
the groups. Celecoxib treatment significantly reduced the volumes of edema noted on
follow-up brain CT scans as compared with the volumes in the control group (30.2±17.7 vs. 55.5±40.6 mL, p=0.027) and also reduced the ratio of initial hematoma and edema volumes vs. the follow-up
volumes as compared with those of the control group (hematoma, 0.90±0.29 vs. 1.54±1.12, p=0.035; edema, 0.95±0.32 vs. 2.08±0.88, p<0.001). The incidences of adverse events during the admission were not different between
the groups. These results suggest that celecoxib may be safe and efficacious in patients
with primary ICH. To confirm this notion, a large-sized prospective study should be
performed.
Keywords
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References
- Spontaneous intracerebral hemorrhage.N Engl J Med. 2001; 344: 1450-1460
- Long-term mortality, morbidity and hospital care following intracerebral hemorrhage: an 11-year cohort study.Cerebrovasc Dis. 2007; 23: 221-228
- Early hemorrhage growth in patients with intracerebral hemorrhage.Stroke. 1997; 28: 1-5
- Early presentation of hemispheric intracerebral hemorrhage: prediction of outcome and guidelines for treatment allocation.Neurology. 1994; 44: 133-139
- Time course of cerebral swelling in stroke: a correlative autopsy and CT study.Adv Neurol. 1980; 28: 395-412
- Stroke epidemiology: a review of population-based studies of incidence, prevalence, and case-fatality in the late 20th century.Lancet Neurol. 2003; 2: 43-53
- Treatment of acute intracerebral hemorrhage with epsilon-aminocaproic acid: a pilot study.Neurocrit Care. 2004; 1: 47-51
- Dexamethasone as treatment in cerebrovascular disease. 2. A controlled study in acute cerebral infarction.Stroke. 1973; 4: 547-555
- Steroid treatment in primary intracerebral haemorrhage.Acta Neurol Belg. 1989; 89: 7-11
- Effects of dexamethasone in primary supratentorial intracerebral hemorrhage.N Engl J Med. 1987; 316: 1229-1233
- Citicoline in intracerebral haemorrhage: a double-blind, randomized, placebo-controlled, multi-centre pilot study.Cerebrovasc Dis. 2006; 21: 380-385
- Effect of single mannitol bolus in intracerebral hemorrhage.Eur J Neurol. 2007; 14: 1118-1123
- Gavestinel does not improve outcome after acute intracerebral hemorrhage: an analysis from the GAIN International and GAIN Americas studies.Stroke. 2005; 36: 1006-1010
- Results in 95 hemorrhagic stroke patients included in CLASS, a controlled trial of clomethiazole versus placebo in acute stroke patients.Stroke. 2000; 31: 82-85
- Celecoxib induces functional recovery after intracerebral hemorrhage with reduction of brain edema and perihematomal cell death.J Cereb Blood Flow Metab. 2004; 24: 926-933
- Coxibs and heart disease: what we have learned and what else we need to know.J Am Coll Cardiol. 2007; 49: 1-14
- Efficacy and safety of etoricoxib 30 mg and celecoxib 200 mg in the treatment of osteoarthritis in two identically designed, randomized, placebo-controlled, non-inferiority studies.Rheumatology (Oxford). 2007; 46: 496-507
- COX-2 inhibitors celecoxib and parecoxib: valuable options for postoperative pain management.Curr Top Med Chem. 2007; 7: 235-249
- Guidelines for the management of spontaneous intracerebral hemorrhage in adults: 2007 update: a guideline from the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Outcomes in Research Interdisciplinary Working Group.Stroke. 2007; 38: 2001-2023
- Hepatic volumetry with PhotoShop in personal computer.Hepatobiliary Pancreat Dis Int. 2004; 3: 82-85
- Cyclooxygenases and central nervous system inflammation: conceptual neglect of cyclooxygenase 1.Arch Neurol. 2003; 60: 630-632
- Cyclooxygenases in central nervous system diseases: a special role for cyclooxygenase 2 in neuronal cell death.Arch Neurol. 2003; 60: 628-630
- Cyclooxygenase-2 and stroke: the long and short of it.Ann Neurol. 2003; 54: 141-142
- Cyclooxygenase 2 inhibition protects motor neurons and prolongs survival in a transgenic mouse model of ALS.Ann Neurol. 2002; 52: 771-778
- The coxibs, selective inhibitors of cyclooxygenase-2.N Engl J Med. 2001; 345: 433-442
- Celecoxib, a selective cyclooxygenase-2 inhibitor, decreases monocyte chemoattractant protein-1 expression and neointimal hyperplasia in the rabbit atherosclerotic balloon injury model.J Cardiovasc Pharmacol. 2005; 45: 61-67
- Effect of celecoxib on restenosis after coronary angioplasty with a Taxus stent (COREA-TAXUS trial): an open-label randomised controlled study.Lancet. 2007; 370: 567-574
- Cyclooxygenase-2 inhibitor ns-398 protects neuronal cultures from lipopolysaccharide-induced neurotoxicity.Stroke. 2001; 32: 2370-2375
- Reduced susceptibility to ischemic brain injury and N-methyl-d-aspartate-mediated neurotoxicity in cyclooxygenase-2-deficient mice.Proc Natl Acad Sci U S A. 2001; 98: 1294-1299
- The cyclooxygenase-2 inhibitor NS-398 ameliorates ischemic brain injury in wild-type mice but not in mice with deletion of the inducible nitric oxide synthase gene.J Cereb Blood Flow Metab. 1999; 19: 1213-1219
- Long-term efficacy and safety of celecoxib in Alzheimer's disease.Dement Geriatr Cogn Disord. 2007; 23: 8-21
- Cardiovascular risk of celecoxib in 6 randomized placebo-controlled trials: the cross trial safety analysis.Circulation. 2008; 117: 2104-2113
Administration of celecoxib for treatment of intracerebral hemorrhage: a pilot study (ACE-ICH). http://clinicaltrialsgov/show/NCT00526214.
Article info
Publication history
Published online: January 27, 2009
Accepted:
December 17,
2008
Received in revised form:
October 31,
2008
Received:
June 6,
2008
Identification
Copyright
© 2008 Elsevier B.V. Published by Elsevier Inc. All rights reserved.