Effects of celecoxib and naproxen on renal function in the elderly

Objective: To compare the effects of celecoxib, a cyclooxygenase 2- specific inhibitor, with the nonspecific cyclooxygenase 1 and 2 inhibitor naproxen on renal function in 29 healthy elderly subjects in a single-blind, randomized, crossover study. Methods: Subjects received either celecoxib, 200 mg twice daily, for 5 days followed by celecoxib, 400 mg twice daily, for the next 5 days, or they received naproxen, 500 mg twice daily, for 10 days. After a 7-day washout, subjects were crossed over to receive the other regimen. Results: After the first dose, the trend was for a greater decrease in glomerular filtration rate with naproxen (-5.31 mL/min per 1.73 m²) compared with celecoxib (-0.86 mL/min per 1.73 m²). The treatment difference became statistically significant on day 6 (-7.53 vs -1.11 mL/min per 1.73 m² for naproxen and celecoxib, respectively; P=.004). Urinary prostaglandin E₂ and 6-keto-prostaglandin F(1α) excretion was significantly reduced from baseline across the treatment interval with both celecoxib and naproxen (P≤.04). There were no significant differences in prostaglandin excretion between these 2 agents (P≥.07). Small, transient decreases (P2 and 6-keto-prostaglandin F(1α) excretion, appear to be similar to those of nonspecific cyclooxygenase inhibitors such as naproxen.