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Use of Cyclo-Oxygenase Inhibitors Is Not Associated with Clinical Relapse in Inflammatory Bowel Disease: A Case-Control Study

1
Norwich Medical School, University of East Anglia, Norwich 06360, UK
2
Department of Gastroenterology, Norfolk and Norwich University Hospital, Norwich 06360, UK
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Author to whom correspondence should be addressed.
Academic Editor: Jane McHowat
Pharmaceuticals 2015, 8(3), 512-524; https://doi.org/10.3390/ph8030512
Received: 23 July 2015 / Revised: 16 August 2015 / Accepted: 25 August 2015 / Published: 7 September 2015
(This article belongs to the Special Issue Non-Steroidal Anti-Inflammatory Drugs)
Patients with inflammatory bowel disease (IBD) often have associated conditions, for which anti-inflammatory medication with cyclo-oxygenase (COX) inhibitors may be helpful. The current evidence is conflicting regarding the role of COX-inhibitors in causing relapse in IBD. This case-control study examined the association between the use of COX inhibitors and relapse of IBD. Logistic regression was used to analyse the relationship between COX-inhibitors and IBD relapse. Overall COX inhibitor use (combined non-steroidal anti-inflammatory drugs (NSAIDs) and selective COX-2 agents) had a negative association with relapse of IBD (adjusted OR 0.26, 95% CI 0.09–0.80). This negative association was confined to ulcerative colitis (UC) (adjusted OR = 0.06, 95% CI 0.01–0.50) and no association was found in Crohn’s disease (CD) patients (adjusted OR 1.25, 95% CI 0.18–7.46). The significant negative association between UC relapse and medication use was also seen with non-specific NSAIDs. Selective COX-2 inhibitor use was rare but non-significantly more common in stable patients. There was no association between low-dose aspirin or paracetamol use and relapse of CD or UC. We conclude that COX-inhibitor use was not associated with an increased risk of relapse in UC or CD, and may be protective in UC. Where indicated, NSAIDs should not be withheld from IBD patients. View Full-Text
Keywords: Crohn’s disease; Ulcerative colitis; cyclo-oxygenase; non-steroidal anti-inflammatory drug Crohn’s disease; Ulcerative colitis; cyclo-oxygenase; non-steroidal anti-inflammatory drug
MDPI and ACS Style

Hensley, A.; Beales, I.L.P. Use of Cyclo-Oxygenase Inhibitors Is Not Associated with Clinical Relapse in Inflammatory Bowel Disease: A Case-Control Study. Pharmaceuticals 2015, 8, 512-524.

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