Suzanne K. Swan, MD; D. Craig Brater, MD
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Swan S., Brater D.; Cyclooxygenase-2 Inhibition and Renal Function. Ann Intern Med. 2001;134:1078. doi: 10.7326/0003-4819-134-11-200106050-00019
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Published: Ann Intern Med. 2001;134(11):1078.
Substantial data have shown that both celecoxib and rofecoxib cause sodium retention similar to that caused by nonselective NSAIDs. We appreciate the reminder from Pfister and colleagues that other manifestations of sodium retention (such as pleural effusions) can also occur. The primary purpose of our study was to directly compare the peak effects of rofecoxib, indomethacin, and placebo on glomerular filtration rate and other variables of renal function in patients predisposed to such effects. The study that most similarly addresses the same question with celecoxib showed comparable effects (1). In that study, a single 400-mg dose of celecoxib (200 mg twice daily is the highest approved daily dose) caused a significant peak decrease of approximately 13 mL/min in glomerular filtration rate. In our study, a single 250-mg dose of rofecoxib (10 times the highest clinical daily dose) resulted in a significant decrease of 14 mL/min in glomerular filtration rate. No published studies directly compare the two COX-2 inhibitors; those cited by Dr. Whelton are not comparisons. The only trial suggesting a lack of effect of celecoxib on renal function examined a patient sample different from that of our study and obtained glomerular filtration rates at time points that probably missed peak effect (2). Nonetheless, rofecoxib did not affect glomerular filtration rate in that sample.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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