title: Small bowel injury induced by selective cyclooxygenase-2 inhibitors: a prospective, double-blind, randomized clinical trial comparing celecoxib and meloxicam.
abstract: BACKGROUND
  Selective cyclooxygenase (COX)-2 inhibitors are less harmful to the small bowel mucosa than non-selective anti-inflammatory drugs. We aimed to compare the severity of small bowel mucosal injury in healthy volunteers induced by two selective COX-2 inhibitors, celecoxib and meloxicam, in a randomized, double-blind trial, using capsule endoscopy (CE).
  
  
  METHODS
  Twenty-nine healthy subjects were randomized to take either celecoxib (200 mg twice daily) or meloxicam (10 mg once daily) for 2 weeks. The incidence and the number of small bowel mucosal injuries (bleeding, ulcers, and erosions) observed by CE were compared between the two groups.
  
  
  RESULTS
  The overall incidence of small bowel mucosal injury was not different between the celecoxib group (6 of 14 subjects, 42.9%) and the meloxicam group (4 of 15 subjects, 26.7%, P = 0.45). In subjects with positive CE findings, the number of ulcers was greater in the meloxicam group than in the celecoxib group (P = 0.02), while such a trend was not found with regard to erosions (P = 0.52). The distribution of mucosal lesions within the small bowel was similar in the two groups.
  
  
  CONCLUSIONS
  Selective COX-2 inhibitors are not completely safe for the small bowel. The mucosal lesions may be less severe with celecoxib than with meloxicam.
authors.affiliation: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. ymaehata@intmed2.med.kyushu-u.ac.jp
authors.forename: Yuji
authors.initials: Y
authors.lastname: Maehata
authors.forename: Motohiro
authors.initials: M
authors.lastname: Esaki
authors.forename: Toshibumi
authors.initials: T
authors.lastname: Morishita
authors.forename: Shuji
authors.initials: S
authors.lastname: Kochi
authors.forename: Shingo
authors.initials: S
authors.lastname: Endo
authors.forename: Kentaro
authors.initials: K
authors.lastname: Shikata
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Takayuki
authors.initials: T
authors.lastname: Matsumoto
mesh_terms: D000328:Adult; D053705:Capsule Endoscopes; D000068579:Celecoxib; D052246:Cyclooxygenase 2 Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D004311:Double-Blind Method; D004381:Duodenal Ulcer / Q000139:chemically induced*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000187:drug effects / Q000473:pathology*; D007421:Intestine, Small / Q000187:drug effects / Q000473:pathology*; D008297:Male; D000077239:Meloxicam; D008875:Middle Aged; D011446:Prospective Studies; D011720:Pyrazoles / Q000009:adverse effects* / Q000627:therapeutic use; D013449:Sulfonamides / Q000009:adverse effects* / Q000627:therapeutic use; D013843:Thiazines / Q000009:adverse effects* / Q000627:therapeutic use; D013844:Thiazoles / Q000009:adverse effects* / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D052246:Cyclooxygenase 2 Inhibitors; D011720:Pyrazoles; D013449:Sulfonamides; D013843:Thiazines; D013844:Thiazoles; D000068579:Celecoxib; D000077239:Meloxicam