Celebrex prevents adhesions after surgery

Painful surgical adhesions may be preventable by taking the COX-2 inhibitor Celebrex, a common oral arthritis drug, just before and immediately after surgery, report researchers at Children's Hospital Boston. Their findings were published in the January 25 online Annals of Surgery.

Adhesions bands of scar tissue that bind together two internal body surfaces develop in 55 percent to more than 90 percent of patients undergoing surgery, depending on the type of operation. They are part of normal healing, but when surfaces fuse together that shouldn't, serious pain and complications can result. Adhesions are a major cause of bowel obstruction and infertility, and repeat surgery is often needed to cut through them. Unfortunately, adhesions often recur after these surgeries, and there has been no good way of preventing them.

Investigations led by Dr. Mark Puder and Dr. Arin Greene in the Department of Surgery and the Vascular Biology Program at Children's Hospital Boston tested COX-2 inhibitors in an animal model of abdominal adhesion formation. After undergoing surgery, groups of 6 to 18 mice received either COX-2 inhibitors (Celebrex or Vioxx), non-selective COX inhibitors (such as ibuprofen and aspirin) or placebo for 10 days.

"Results were dramatic," says Puder, senior investigator on the study.

At 10 days, the placebo group had obvious abdominal adhesions. Mice receiving non-selective COX inhibitors had a slight reduction in adhesions, and the COX-2 inhibitor group had a larger reduction. The greatest reduction was in the mice given Celebrex, and 6 of 11 Celebrex-treated mice (55%) were completely adhesion-free.

The researchers then observed the Celebrex, Vioxx, aspirin and placebo groups for an additional 25 days. Again, the Celebrex group had the fewest adhesions. The adhesion score (a measure of both the extent of adhesions and the difficulty of removing them) was only 1 in the Celebrex group, 5 in the Vioxx group,

Contact: Susan Craig
Children's Hospital Boston

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