Article Text

Download PDFPDF

Celecoxib for colorectal adenomas increased CV events

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

 Q In patients with a history of colorectal neoplasia who are at risk of recurrent adenomatous polyps, how safe is celecoxib with respect to cardiovascular (CV) events?

Clinical impact ratings GP/FP/Primary care ★★★★★★☆ IM/Ambulatory care ★★★★★★☆ Oncology ★★★★★☆☆ Gastroenterology ★★★★★☆☆ Cardiology ★★★★★☆☆


Embedded ImageDesign:

randomised placebo controlled trial (Adenoma Prevention with Celecoxib [APC] Study).

Embedded ImageAllocation:

unclear allocation concealment.*

Embedded ImageBlinding:

blinded (clinicians, patients, judicial assessors of outcomes, and monitoring committee).*

Embedded ImageFollow up period:

2.8–3.1 years.

Embedded ImageSetting:

91 sites in the US, Canada, Australia, and the UK.

Embedded ImagePatients:

2035 patients 32–88 years of age (mean age 60y, 68% men) who had had endoscopic polypectomy to remove colorectal adenomas.

Embedded ImageIntervention:

twice daily celecoxib, 200 mg (n = 685); celecoxib, 400 mg (n = 671); or placebo (n = 679). Patients were stratified by centre and use or non-use of aspirin for CV prophylaxis.

Embedded ImageOutcomes:

composite endpoint of death from CV causes, myocardial infarction (MI), stroke, or heart failure. Secondary composite endpoints included the addition of angina and need for a CV procedure.

Embedded ImagePatient follow up:

all patients completed at least 2.8–3.1 years of follow up (intention to treat analysis).


The trial was stopped early with a 77% completion rate. 800 mg/day of celecoxib led to a greater risk of the CV composite endpoint than did placebo (table). The risk decreased slightly when angina (hazard ratio [HR] 2.3, 95% CI 1.1 to …

View Full Text