The Association between Cyclo-oxygenase Inhibitor Medications and Clinical Relapse in Inflammatory Bowel Disease: Review of Current Perspectives
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2015, Vol 5, Issue 4
Abstract
Background: Patients with inflammatory bowel disease (IBD) often have associated conditions which may benefit from treatment with non-steroidal anti-inflammatory drugs (NSAIDs) or selective cyclo-oxygenase-2 (COX-2) inhibitors. However, evidence has suggested there may be an association between COX- inhibition and relapse in IBD, which leads to clinicians being reluctant to prescribe these agents. Aims: The aim of this review is to review the possible biological mechanisms, linking NSAIDs and IBD-relapse and current knowledge on the possible association of NSAIDs and clinical relapse in IBD. Results: IBD relapse due to NSAID use is most likely due to prostaglandin inhibition via dual COX-inhibition, although the topical effect of NSAIDs on the intestine may also play a role. The evidence for an association between NSAIDs and IBD relapse is contradictory and generally weak, but it is likely a small percentage of patients relapse when taking NSAIDs, but it is not known which patients are at risk. Mixed results have also been obtained from studies examining COX-2 selective agents; although a single randomized controlled-trial showed that celecoxib is safe in ulcerative colitis in the short term. Conclusions: At present the data are contradictory and most published studies have serious flaws. Overall the association between use of NSAIDs and IBD-relapse seems rather weak, Cyclo-oxygenase inhibitors should not be withheld from stable IBD patients, if clinically indicated and appropriate cautions and monitoring are used. Celecoxib would seem a sensible first choice. Further studies are needed to help identify which patients are at risk of relapse with NSAIDs.
Authors and Affiliations
Abigail Hensley, Ian L. P. Beales
Keywords
Related Articles
- EP ID EP344992
- DOI 10.9734/BJMMR/2015/13064
- Views 79
- Downloads 0
Perceived Parental Behaviour as Predictor of In-school Adolecent Sexual Risk Behaviour in Ibadan, Nigeria
Sexual risk behavior among youth, defined as early sexual initiation, unprotected intercourse, or sex with multiple partners, is a major area of concern to parents or caregivers and the health professionals given the man...
Review of Genotoxic Effects for Pesticides Exposure among Rural Community in a Farming Village
Background: Past studies have suggested that early exposure of farm children to chronic pesticides were likely to establish genotoxic risk that might lead to cancerous cell development later during their adulthood (if no...
Oral Anti-Diabetic Agents-Review and Updates
Diabetes is a chronic metabolic disorder with high mortality rate and with defects in multiple biological systems. Two major types of diabetes are recognized, type 1 and 2 with type 2 diabetes (T2D) being by far the more...
Effect of Submaximal Isometric Exercise on the Relationship between Body Mass Index (BMI) and Blood Pressure (BP)
One of the major determinants of desirable body weights is the body mass index (BMI). In humans, BMI is the ratio of body weight (in kg) to height (in meters square). Helpful to clinicians in estimating average healthy w...
Thrombophilic Mutations and Folate Gene Polymorphisms and Plasminogen Activator Inhibitor-1 in Russian Women with Unexplained Recurrent Early Spontaneous Abortion
Aims: To assess the association between FVL G1691A, FII G20210A, MTHFR A1298C, C677T and PAI-1 5G/675/4G gene polymorphisms among women with unexplained recurrent early spontaneous abortion (URESA) Materials and Methods...