Celecoxib 200 Mg (Page 4 of 9)
6.2 The Celecoxib Long-Term Arthritis Safety Study
Hematological Events : The incidence of clinically significant decreases in hemoglobin (>2 g/dL) was lower in patients on celecoxib 400 mg twice daily (0.5%) compared to patients on either diclofenac 75 mg twice daily (1.3%) or ibuprofen 800 mg three times daily 1.9%. The
lower incidence of events with celecoxib was maintained with or without ASA use [see Clinical Pharmacology (12.2)].
Withdrawals/Serious Adverse Events: Kaplan-Meier cumulative rates at 9 months for withdrawals due to adverse events for celecoxib, diclofenac and ibuprofen were 24%, 29%, and 26%, respectively. Rates for serious adverse events (i.e., causing hospitalization or felt tobe life-threatening or otherwise medically significant), regardless of causality, were not different across treatment groups (8%, 7%, and 8%, respectively).
6.3 Juvenile Rheumatoid Arthritis Study
In a 12-week, double-blind, active-controlled study, 242 JRA patients 2 years to 17 years of age were treated with celecoxib or naproxen; 77 JRA patients were treated with celecoxib 3 mg/kg BID, 82 patients were treated with celecoxib 6 mg/kg BID, and 83 patients were treated with naproxen 7.5 mg/kg BID. The most commonly occurring (>5%) adverse events in celecoxib treated patients were headache, fever (pyrexia), upper abdominal pain, cough, nasopharyngitis, abdominal pain, nausea, arthralgia, diarrhea and vomiting. The most commonly occurring (>5%) adverse experiences for naproxen-treated patients were headache, nausea, vomiting, fever, upper abdominal pain, diarrhea, cough, abdominal pain, and dizziness (Table 2). Compared with naproxen, celecoxib at doses of 3 and 6 mg/kg BID had no observable deleterious effect on growth and development during the course of the 12-week doubleblind study. There was no substantial difference in the number of clinical exacerbations of uveitis or systemic features of JRA among treatment groups.In a 12-week, open-label extension of the double-blind study described above, 202 JRA patients were treated with celecoxib 6 mg/kg BID. The incidence of adverse events was similar to that observed during the double-blind study; no unexpected adverse events of clinical importance emerged.
Table 2: Adverse Events Occurring in >5% of JRA Patients in Any Treatment Group, by System Organ Class (% of patients with events)
All Doses Twice Daily | |||
System Organ ClassPreferred Term | Celecoxib 3 mg/kgN=77 | Celecoxib 6 mg/kgN=82 | Naproxen 7.5 mg/kgN=83 |
Any Event | 64 | 70 | 72 |
Eye Disorders | 5 | 5 | 5 |
Gastrointestinal | 26 | 36 | 36 |
Abdominal pain NOS | 4 | 7 | 7 |
Abdominal pain upper | 8 | 6 | 10 |
Vomiting NOS | 3 | 6 | 11 |
Diarrhea NOS | 5 | 4 | 8 |
Nausea | 7 | 4 | 11 |
General | 13 | 11 | 18 |
Pyrexia | 8 | 9 | 11 |
Infections | 25 | 20 | 27 |
Nasopharyngitis | 5 | 6 | 5 |
Injury and Poisoning | 4 | 6 | 5 |
Investigations* | 3 | 11 | 7 |
Musculoskeletal | 8 | 10 | 17 |
Arthralgia | 3 | 7 | 4 |
Nervous System | 17 | 11 | 21 |
Headache NOS | 13 | 10 | 16 |
Dizziness (excl vertigo) | 1 | 1 | 7 |
Respiratory | 8 | 15 | 15 |
Cough | 7 | 7 | 8 |
Skin & Subcutaneous | 10 | 7 | 18 |
*Abnormal laboratory tests, which include: Prolonged activated partial thromboplastin time, Bacteriuria NOS present, Blood creatine phosphokinase increased, Blood culture positive, Blood glucose increased, Blood pressure increased, Blood uric acid increased, Hematocrit
decreased, Hematuria present, Hemoglobin decreased, Liver function tests NOS abnormal, Proteinuria present, Transaminase NOS increased, Urine analysis abnormal NOS
6.4 Other Pre-Approval Studies
Adverse Events from Ankylosing Spondylitis Studies: A total of 378 patients were treated with celecoxib in placebo- and active-controlled AS studies. Doses up to 400 mg once daily were studied. The types of adverse events reported in the AS studies were similar to those reported in the OA/RA studies.
Adverse Events from Analgesia and Dysmenorrhea Studies: Approximately 1,700 patients were treated with celecoxib in analgesia and dysmenorrhea studies. All patients in post-oral surgery pain studies received a single dose of study medication. Doses up to 600
mg/day of celecoxib were studied in primary dysmenorrhea and post-orthopedic surgery pain studies. The types of adverse events in the analgesia and dysmenorrhea studies were similar to those reported in arthritis studies. The only additional adverse event reported was postdental extraction alveolar osteitis (dry socket) in the post-oral surgery pain studies.
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