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Celecoxib for systemic lupus erythematosus: case series and literature review of the use of NSAIDs in SLE

Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA

D J Wallace

Division of Rheumatology, Cedars-Sinai Medical Center; Department of Medicine, UCLA School of Medicine, Los Angeles, California, USA

M H Weisman

Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles; Department of Medicine, UCLA School of Medicine Los Angeles CA 90048, USA. Weisman{at}cshs.org

The primary objectives of this study were to evaluate the safety and efficacy of the cyclooxygenase-2 inhibitor celecoxib in systemic lupus erythematosus (SLE) patients both with and without a self-reported sulfa drug allergy and to review the literature on the use of nonsteroidal agents in SLE subjects. A retrospective review of medical records was performed for 50 SLE patients seen by a community-based rheumatologist and treated with open label celecoxib in doses of 200–400 mg/day for a period of 1–9 months. A MEDLINE search of all articles pertaining to the use of NSAIDs in patients with SLE since 1966 was undertaken.

We noted that, in this cohort of celecoxib-treated SLE patients from an office rheumatology practice, the majority demonstrated some improvement, and little toxicity was observed. SLE patients with self-reported sulfa allergies were not more likely to have adverse reactions to celecoxib than non-sulfa allergic patients. The literature review performed herein reveals that, although NSAID toxicity should be a continuing concern in an SLE population, structural dissimilarities between celecoxib and the sulfonamide antimicrobials may make true crossallergenicity less likely to be a clinical problem. These results suggest that patients with SLE can be safely and effectively treated with celecoxib; however, further studies are needed to assess the effectiveness and safety of all NSAIDs in SLE.

Key Words: celecoxib • cyclo-oxygenase 2 inhibitors • systemic lupus erythematosus • NSAIDs

Lupus, Vol. 11, No. 6, 340-347 (2002)
DOI: 10.1191/0961203302lu204oa


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