Health Canada would like to inform patients using Celebrex(celecoxib) of increased cardiovascular risks when taken at daily doses of 400 mg and 800 mg.
In Canada, the 800 mg daily dose of CelebrexÂ® (celecoxib) received conditional approval in April 2002 for a rare genetic disease, Familial Adenomatous Polyposis, which is highly predictive of colorectal cancer. Other conditions for which the 400 mg daily dosage is approved include rheumatoid arthritis and management of acute pain.
New information was reported today demonstrating serious cardiovascular risks in one of two cancer prevention studies. This trial, which used 400 mg and 800 mg daily doses, was conducted by the National Cancer Institute in the United States. In this trial, the effect of Celebrex(celecoxib) was compared to placebo and the study showed increased risks for serious cardiovascular events. At the 400 mg daily dose the risk was 2.5 times higher. For the 800 mg daily dose the risk was 3.4 times higher. Although the full analysis has not been transmitted to Health Canada, these events seem to be confined to acute heart attack, stroke and sudden cardiac death events.
The second trial, sponsored by Pfizer, used a 400 mg daily dose of Celebrex(celecoxib) and has not shown an increased risk for cardiovascular events to date. However, based on the results of the first trial, the use of Celebrex in both trials has been stopped.
Celebrex(celecoxib) should not be taken for the prevention of recurrence of Familial Adenomatous Polyposis and patients should discuss alternative therapeutic options with their doctors.
Health Canada also advises patients who are on long-term 400 mg daily doses of Celebrex(celecoxib) to discuss alternative therapies with their physician.
Health Canada has notified Pfizer that the market authorization for the use of CelebrexÂ® (celecoxib) for the prevention of recurrence of Familial Adenomatous Polyposis is withdrawn, effective today.
Health Canada will shortly issue further advice concerning the safety of selective COX-2 inhibitor NSAIDs.