Study ties arthritis pain reliever to heart valve disease
27 February, 2019
A recent study has linked a common prescription drug that people with arthritis use to relieve pain and inflammation to a heart valve problem.
The drug, which has the generic name celecoxib and the brand name Celebrex, belongs to a category of nonsteroidal anti-inflammatory drugs (NSAIDs) known as COX-2 inhibitors.
After analyzing thousands of electronic medical records, scientists at Vanderbilt University in Nashville, TN, found a link between using celecoxib specifically and a higher chance of having aortic stenosis.
Aortic stenosis is a condition that narrows the aortic valve in the heart and restricts blood flow through it. It commonly results from scarring and calcification, or calcium buildup, during aging.
In laboratory tests, the researchers also found that treating aortic valve cells with celecoxib increased calcification of the cells.
These findings, now published in JACC: Basic to Translational Science, appear to contradict a 2016 NEJM study that declared that celecoxib was no riskier for the heart than the older NSAIDs naproxen and ibuprofen.
However, the authors note that the earlier study focused "on acute, relatively short-term, and thrombotic events," and did not examine outcomes related to valve disease, which takes longer to develop.
"In this study," says first author Meghan A. Bowler, Ph.D., who worked on the investigation in the Department of Biomedical Engineering, "we're adding a long-term perspective on celecoxib use."
Aortic stenosis and aging
Aortic stenosis is a stiffening of the valve that sits between the aorta and the left ventricle of the heart. The stiffening causes blood to pass less easily from the heart into the aorta, from which it then flows to the rest of the body.
While some people have aortic stenosis because of a birth defect, the most common cause is the buildup of calcium deposits and scarring during aging.
In their study paper, the authors note that more than 1 in 4 people over the age of 65 in the United States have the type of aortic stenosis that develops from calcium buildup.
The disease is progressive and, due to the lack of suitable drugs, the only effective treatment is to replace the valve surgically.
It was concern about the lack of effective drugs that spurred the researchers to investigate the already-approved celecoxib as a treatment for aortic stenosis.
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