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The use of non-steroidal anti-inflammatory drugs (NSAIDs) for a wide range of diseases is increasing, in part due to an increasing elderly population. Elderly patients are more vulnerable to adverse drug reactions, including side effects and adverse effects of drug-drug interactions, often occurring in this category of patients due to multimorbidity and polypharmacy. One of the most popular NSAIDs in the world is celecoxib. It is a selective cyclooxygenase (COX)-2 inhibitor with 375 times more COX-2 inhibitory activity than COX-1. As a result, celecoxib has a better gastrointestinal tract safety profile than non-selective NSAIDs. Gastrointestinal tolerance is an essential factor that physicians should consider when selecting NSAIDs for elderly patients. Celecoxib can be used in a wide range of diseases of the musculoskeletal system and rheumatological diseases, for the treatment of acute pain in women with primary dysmenorrhea, etc. It is also increasingly used as part of a multimodal perioperative analgesia regimen. There is strong evidence that COX-2 is actively involved in the pathogenesis of ischemic brain damage, as well as in the development and progression of neurodegenerative diseases, such as Alzheimer's disease. NSAIDs are first-line therapy in the treatment of acute migraine attacks. Celecoxib is well tolerated in patients with risk factors for NSAID-associated nephropathy. It does not decrease the glomerular filtration rate in elderly patients and patients with chronic renal failure. Many meta-analyses and epidemiological studies have not confirmed the increased risk of cardiovascular events reported in previous clinical studies and have not shown an increased risk of cardiovascular events with celecoxib, irrespective of dose. COX-2 activation is one of the key factors contributing to obesity-related inflammation. Specific inhibition of COX-2 by celecoxib increases insulin sensitivity in overweight or obese patients. Combination therapies may be a promising new area of treatment for obesity and diabetes.

Effective pain control is one of the main goals in the treatment of patient with musculoskeletal disorders. The main suffering of patients is associated with pain: decrease in working capacity and quality of life, disability and severe psycho-emotional disturbances. The pathogenesis of musculoskeletal pain is complex and includes damage (due to an autoimmune process, mechanical or metabolic stress), inflammation, peripheral and central sensitization, degenerative processes (neoangiogenesis, heterotopic ossification, fibrosis), muscle tension, psychoemotional disorders (depression, anxiety), negative behavioral reactions. Pain treatment should be comprehensive and include pharmacotherapy as well as non-pharmacological therapy and rehabilitation methods.Nonsteroidal anti-inflammatory drugs (NSAIDs) are at the forefront of pain treatment. They are effective, convenient and affordable, but can cause a wide range of complications. A personalized approach to pain management is therefore based on the choice of the “right” NSAID. Based on the balance between efficacy and safety, celecoxib can be considered the first choice. It has an extensive evidence base confirming its therapeutic potential in acute pain, osteoarthritis, chronic back pain, systemic rheumatic diseases and other pathologies, as well as a relatively low risk of gastrointestinal and cardiovascular complications. The prescription of celecoxib should be personalized: for severe pain and systemic rheumatic diseases, treatment should be started with a dose of 400 mg/day (600 mg can be used on the first day), followed by a transition to a maintenance dose of 200 mg/day once pain control is achieved.

The combined use of drugs with different mechanisms of action is the main principle of musculoskeletal pain control in rheumatic diseases. However, there are few studies evaluating the efficacy of this approach in real practice.Objective: to determine the efficacy and safety of the combined use of celecoxib, diacerein, and the combination of glucosamine + chondroitin in osteoarthritis (OA) and chronic nonspecific low back pain (NSLBP). Material and methods. Statistical analysis of data obtained during a 3-month open observational study was performed. We included 1569 patients (63.6 % women and 36.4 % men, mean age 58.7 ± 11.0 years) with knee OA (kOA), hip OA (hOA), generalized OA (gOA), and chronic NSLBP with moderate/severe pain (≥ 4 on a numeric rating scale, NRS 0–10) who required nonsteroidal anti-inflammatory drugs. Celecoxib 200 mg twice daily was prescribed, with the dose reduced to 200 mg per day or taken “as needed" after significant pain relief; diacerein 50 mg twice daily; and a medication of glucosamine 250 mg and chondroitin 200 mg, 2 capsules 2–3 times daily. Outcomes were assessed after 3 months using the dynamics of pain, fatigue, dysfunction (according to NRS), and the “Patient Acceptable Symptom State” (PASS) indicator. Results and discussion. 80.2 % of patients completed the 3 month course of treatment, 4.4 % discontinued treatment due to adverse events (AEs), and for 15.4 % of patients there was no follow-up. After 3 months of treatment ≥ 50 % decrease (from baseline) in the severity of symptoms was noted in 83.4 % of patients for pain on movement, in 83.7 % for pain at rest, in 78.6 % for pain at night, in 80.8 % for dysfunction, and in 83.4 % for fatigue. 87.7 % of patients reported PASS. There were no significant differences in treatment outcomes for different localizations of OA and NSLBP: a ≥ 50 % pain reduction in kOA was achieved in 81.6 % of patients, in hOA – in 82.2 %, in gOA – in 85.0 %, in NSLBP – in 88.1 %. AEs were registered in 350 (22.4 %) patients, the most frequent was dyspepsia (n = 280, 17.8 %), diarrhea was recorded in 37 (2.4 %) cases. No serious AEs requiring hospitalization were registered. Conclusion. Combination therapy with celecoxib, diacerein, and a combination of glucosamine and chondroitin significantly reduces the severity of symptoms of OA and NSLBS.

Musculoskeletal diseases, such as osteoarthritis (OA), nonspecific back pain (NBP), and periarticular soft tissue pathology (PSTP – tendinitis, enthesitis, bursitis, etc.) are one of the most common reasons for visiting general practitioners. The treatment of this pathology is based on the complex use of drugs and non-drug methods for maximum pain control and lost function restoration. Considering the common pathogenesis of musculoskeletal pain in OA, NBP, and PSTP, it is advisable to base the therapy of these diseases on a single algorithm. Of course, when prescribing treatment, one should take into account "red flags" (symptoms of life threatening diseases), features of the clinical course, patient's psycho-emotional condition, and comorbid diseases.Development of a unified tactic for the treatment of musculoskeletal pain will significantly reduce the time spent on a diagnostic search and the choice of adequate therapy, which will facilitate the work of a general practitioner. Thus, non-drug approaches (patient education, kinesiotherapy, psychotherapeutic methods, etc.), non-steroidal anti-inflammatory drugs (NSAIDs) and symptomatic slow-acting drugs (SYSADOA) seem to be the most rational approach in the debut of the treatment of OA, NBP and PSTP. Among NSAIDs, celecoxib seems to be one of the optimal drugs in terms of efficacy and safety, and among SYSADOAs – diacerein. There is evidence that the combined use of these drugs may increase their analgesic and anti-inflammatory potential.

Introduction. To reduce frequency of taking celecoxib dosage forms, as a highly effective drugs of the latest generation for the treatment of inflammatory diseases of the musculoskeletal system, it is advisable to develop pharmaceutical dosage form with modified release, which will reduce side effects and costs treatment.Aim. The purpose of this study was to develop formulations of prolonged release celecoxib granules.Materials and methods. Experiments were carried out with materials and equipments of the scientific laboratories of the company LEM pharma (Hama, Syria). The physico-chemical and technological properties of the experimental samples of granules and tablets of celecoxib were determined according to the methods of the American Pharmacopoeia USP 41 NF 36 edition.Results and discussion. The choice of excipients, in particular, cellulosic polymers to control releasing celecoxib was carried out. The compositions of six model samples of celecoxib granules were proposed. The technological characteristics of the samples of granules (index Hausner, Carr ratio, Particle size distribution and moisture content) have been determined, using a dissolution test, their suitability for obtaining capsules and matrix tablets of prolonged release has been established.Conclusion. The compositions of granules celecoxib with modified release are developed, which can be used to obtain capsules, as well as matrix tablets as the final pharmaceutical form.

The use of non-steroidal anti-inflammatory drugs (NSAIDs) for a wide range of diseases is increasing, in part due to an increasing elderly population. Elderly patients are more vulnerable to adverse drug reactions, including side effects and adverse effects of drug-drug interactions, often occurring in this category of patients due to multimorbidity and polypharmacy. One of the most popular NSAIDs in the world is celecoxib. It is a selective cyclooxygenase (COX)-2 inhibitor with 375 times more COX-2 inhibitory activity than COX-1. As a result, celecoxib has a better gastrointestinal tract safety profile than non-selective NSAIDs. Gastrointestinal tolerance is an essential factor that physicians should consider when selecting NSAIDs for elderly patients. Celecoxib can be used in a wide range of diseases of the musculoskeletal system and rheumatological diseases, for the treatment of acute pain in women with primary dysmenorrhea, etc. It is also increasingly used as part of a multimodal perioperative analgesia regimen. There is strong evidence that COX-2 is actively involved in the pathogenesis of ischemic brain damage, as well as in the development and progression of neurodegenerative diseases, such as Alzheimer's disease. NSAIDs are first-line therapy in the treatment of acute migraine attacks. Celecoxib is well tolerated in patients with risk factors for NSAID-associated nephropathy. It does not decrease the glomerular filtration rate in elderly patients and patients with chronic renal failure. Many meta-analyses and epidemiological studies have not confirmed the increased risk of cardiovascular events reported in previous clinical studies and have not shown an increased risk of cardiovascular events with celecoxib, irrespective of dose. COX-2 activation is one of the key factors contributing to obesity-related inflammation. Specific inhibition of COX-2 by celecoxib increases insulin sensitivity in overweight or obese patients. Combination therapies may be a promising new area of treatment for obesity and diabetes.

No effect of outpatient treatment is observed in some patients with acute nonspecific lumbodynia and lumbar ischialgia; therefore they are referred to pain management departments or centers for specialized examination and treatment.Objective: to study of the anatomical causes of pain and the efficiency of celecoxib (Dilaxa) treatment in patients with acute and subacute lumbodynia and lumbar ischialgia in the inpatient setting.Patients and methods. Eighty patients (47 women and 33 men; mean age, 51.0±15.3 years) with acute and subacute lumbodynia (n=11) or lumbar ischialgia (n=69) were followed up. Pain intensity was assessed using a visual analogue scale (VAS); functional limitation was rated according to the Roland–Morris scale (RMS). To reduce the intensity of pain syndrome, patients took oral celecoxib (Dilaxa) 200 mg twice daily. Therapeutic blockades with anesthetics and glucocorticoids were used in some cases of damage to the sacroiliac joint (SIJ) or facet joints (FJ). Patients were informed of the benign nature of the disease; they did therapeutic exercises.Results and discussion. The causes of pain were ascertained to be injuries of SIJ (48,8%), FJ and SIJ (18,8%), FJ (17,5%), herniated disc (10%), piriformis syndrome (2.5%), and piriformis syndrome and SIJ injury (2.5%). The duration of treatment averaged 11.0±2.4 days. By the end of the study, there was a clinically significant reduction in pain in 86% of patients. The treatment resulted in a 2.4-fold average reduction in pain intensity (from 7.0 to 2.9 VAS scores): a 4-fold reduction in patients with lumbodynia (from 6.4 to 1.6 scores) and a 2.3-fold one in those with lumbar ischialgia (from 7.1 to 3.1. scores); the degree of disability reduced by an average of 1.9 times (from 8.1 to 4.3 RMS scores): by 3.6 times (from 6.8 to 1.9 scores) and 1.9 (from 8,3 to 4,7 scores) times in patients with lumbodynia and in those with lumbar ischialgia, respectively. No adverse events were observed during the treatment period.Conclusion. There were high SIJ and FJ injury rates in subacute lumbar ischialgia. Celecoxib was noted to be highly effective and safe in treating acute and subacute lumbar ischialgia and lumbodynia.

Neck pain is one of the common causes of maladjustment. Acute neck pain in most cases regresses independently in the period of a few weeks to months; however, it recurs in half of cases. Although the potential specific causes of cervicalgia are rare; nevertheless, in some cases the patient should undergo a detailed examination that is based on the identification of red flags and can optimize a search for the cause of pain syndrome. A consideration of the important principles of classifying pain in acute and chronic, neuropathic and nociceptive pain can serve as an important landmark in choosing the optimal treatment strategy for a patient. Unlike low back pain, neck pain has been investigated in an insufficient number of randomized controlled studies, which makes this analysis extremely relevant. The paper discusses the use of nonsteroidal anti-inflammatory drugs for back pain and the efficacy and safety of celecoxib.

The international multicenter PRECISION study evaluating the cardiovascular safety of celecoxib, naproxen, and ibuprofen is under close scrutiny by critics. One of the criticisms about this study was that the use of relatively low dose (on average just above 200 mg/day) may not be effective enough. But is it really so?This review gives data from numerous international studies dealing with the treatment of osteoarthritis (OA), in which celecoxib 200 mg/day is compared with paracetamol 4000 mg/day, diclofenac 100—150 mg/day, naproxen 1000 mg/day, ibuprofen 2400 mg/day and slow-acting antirheumatic drugs (glucosamine, chondroitin, and their combination). Almost all studies demonstrate that celecoxib 200 mg has a good and rapid analgesic effect that is not inferior to or exceed that of the reference drugs.Celecoxib 200 mg/day could relieve pain in OA for many months and prevent disease recurrences. The low risk of gastrointestinal and cardiovascular complications, which has been confirmed by the PRECISION study, makes celecoxib 200 mg/day the drug of choice for long-term OA therapy, including in patients with serious comorbid conditions.

A new bifunctional ointment with chondroitin sulfate and celecoxib on a hydrophilic base was developed. The optimum conditions of the technology and technological properties of the ointment were determined. The techniques for quantitativecontrol of active components in a bifunctional ointment are developed. Quantitative determination of chondroitin sulfate in an ointment was conducted by turbidimetric titration. A relative error of determination with confidence probability P=95% is not more than 2,01%. Quantitative determination of celecoxib was conducted by spectrophotometry. A relative error of determination with confidence probability P=95% is not more than 3,22%.

Glucosamine sulfate (GS) is essential for the regeneration of cartilaginous tissue and, in addition, it has anti-inflammatory properties comparable to those of nonsteroidal anti-inflammatory drugs (NSAIDs). Clinical trials indicate the synergism between GS and NSAIDs in osteoarthritis (OA) and other joint diseases.Objective: to estimate the degree of synergism between different combinations of GS and NSAIDs.Material and methods. A differential chemoreactome analysis was employed to evaluate the effects of GS and seven agents from the class of NSAIDs, such as ketorolac, nimesulide, diclofenac, meloxicam, dexketoprofen, celecoxib, and etoricoxib, for estimating the degree of synergism between different combinations of GS and NSAIDs.Results and discussion. Dexketoprofen is shown to enhance most effectively the anti-inflammatory properties of GS as compared to ketorolac that does this to a lesser extent. The drug should be practically used as follows: the most effective combination (GS + dexketoprofen (or GS + ketorolak) is taken at week 1 of treatment for rapid pain elimination; thereafter there may be a combination of GS and NSAIDs, the intake of which is associated with minimal adverse reactions for a longer time.Conclusion. The investigation has shown that the coadministration of GS and NSAIDs is promising in treating joint diseases.

Objective: To conduct a comparative cost minimization analysis (CMA) of Movalis with other non-steroidal antiinflammatory drugs (NSAIDs) such as diclofenac, nimesulide, celecoxib and etoricoxib. Methodology: Was conducted search of publications from 1990 to 2014, devoted to randomized controlled clinical trials, a network meta-analysis and systematic reviews (level of evidence: AI) use of NSAIDs in patients with osteoarthritis (OA) and rheumatoid arthritis (RA). The model evaluates economical effectiveness of drugs and the comparison is based on the results of the randomized controlled clinical trials (RCCT), network meta-analyzes and systematic reviews. Since the data RCCT, network meta-analyzes and systematic reviews have shown equal efficacy of NSAIDs, model is a particular drug and CMA consists of one line therapy, providing short-term economic evaluation and impact on the health of patients with OA and RA. Results: The results of used of NSAIDs CMA and treatment of complications in patients with OA and RA showed that the total cost of the Movalis (meloxicam) is lower than another drugs: Voltaren (diclofenac), Nimesil (nimesulide), Celebrex (celecoxib) and Arcoxia (etoricoxib). Costs saving for one patient is favor for Movalis in comparison with the Voltaren was 465 rubles (-8.55%), Celebrex - 1.255 rubles (-23.09%), Arcoxia - 1.274 rubles (-23.43%) for a 1 month of therapy. Sub-analysis of the Movalis compared with the Nimesil (nimesulide) for 15 days of therapy showed that the cost savings per patient is favor for meloxicam will be 1.504 rubles (-117.74%). Sensitivity analysis confirmed these findings: an increase in drug prices Movalis by 25% and reducing the price of the reference drugs by 25%, minimizing the cost figures do not go beyond the parameters of the Movalis that demonstrates the stability of the obtained data in the study.

The results of the PRECISION trial were published in late 2016. During this trial, a total of 24,081 patients at high cardiovascular risk took celecoxib 200-400 mg/day, naproxen 750–1000 mg/day or ibuprofen 1800–2400 mg/day for more than 1.5 years (20.3±16.0 months). The findings show that the frequency of vascular catastrophes (death, nonfatal myocardial infarction, and stroke) in patients receiving celecoxib was not higher than that of the similar complications in those taking the control drugs. At the same time, celecoxib demonstrated a statistically significant advantage in reducing the risk of serious gastrointestinal complications. New evidence refutes the concept of high cardiovascular risk that is common to all coxibs and confirms the provisions of national guidelines for the rational use of nonsteroidal anti-inflammatory drugs (NSAIDs), which were published in 2015. This review presents recent data on the risk of NSAID-related complications, including a brief description of the design and results of the PRECISION trial.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most prescribed drugs worldwide and, like any medication, can cause adverse drug reactions. Since NSAIDs belonging to the group of coxibs, are quite commonly used in clinical practice now, the study of the safety of this class of drugs is given the highest priority. The paper analyzes a largest-scale PRECISION study of the safety of NSAIDs, the aim of which was to assess the cardiovascular safety of celecoxib versus that of ibuprofen and naproxen in patients with osteoarthritis and rheumatoid arthritis

The paper discusses the results of the long-term PRECISION study specially designed for the prospective comparative evaluation primarily of the cardiovascular safety of celecoxib, ibuprofen, and naproxen, which are long used for the treatment of pain in patients with arthritis.

The paper discusses the specific features of using nonsteroidal anti-inflammatory drugs in patients with high cardiovascular risk.

Non-steroid anti-inflammatory drugs (NSAID) were and still remain the main means for arresting acute and controlling chronic pains in therapeutic practice. However, serious complications that may be caused by these drugs essentially limit their application. Therapists need distinct and reasonable guidelines on NSAID prescription depending on presence of a comorbid pathology and risk factors associated with the gastrointestinal tract and cardiovascular system. World renowned experts have been actively studying this problem. The main aspects of NSAID efficiency and safety are discussed in this study; the risk factors are ranked according to their significance; and an algorithm of reasonable drug prescription, including prevention of potential complications, is proposed.

Celecoxib is an effective drug to control chronic pain in rheumatic diseases. It is the only nonsteroidal antiinflammatory drug that has clearly shown the lower frequency of not only upper, but also distal gastrointestinal complications, such as iron-deficiency anemia associated with small bowel pathology. In real clinical practice, the reflection of which is populationbased studies, celecoxib causes cardiovascular events relatively rarely. Its good tolerability and a low risk for gastrointestinal and cardiovascular complications allow its successful use for a long time (if required), without fear of drug-induced complications.

The paper presents the results of a randomized double-blind study of the impact of therapy with celecoxib and a combination of diclofenac and omeprazole in patients with osteoarthrosis and rheumatoid arthritis on a risk for developing gastrointestinal diseases. The study was conducted at health care facilities in 196 centers of 32 countries and covered 18-to-60-year-old patients who belonged to an increased gastrointestinal risk group and had a history of gastroduodenal ulcers and a negative Helicobacter pylori test at screening. The included patients were randomized by a computer program in a 1: 1 ratio to treatment groups receiving celecoxib in a dose of 200 mg twice daily or sustained-release diclofenac 75 mg twice daily + omeprazole 20 mg once daily. The primary efficacy criterion was assessed as the development of clinically relevant changes in the upper or lower gastrointestinal tract (GIT). 4484 patients were randomized to treatment groups (2238 took celecoxib; 2246 received diclofenac + omeprazole). Twenty (0.9%) patients who took celecoxib and 81 (3.8%) who used diclofenac + omeprazole achieved the primary assessment criterion (p

The influence of cyclooxygenase inhibitors on the lymphoid organs histomorphology has been examined in the matured outbread white mice. Diclofenac, meloxicam, celecoxib, but not rofecoxib has shown depressive action on the im-munocompetetive organs histomorphologic structure. Macroscopic study has revealed a decrease in the weight of the spleen and thymus. Light microscopy has shown a decrease in the number of thymocytes, due to degradation of cortex area. In the lobular medulla it has been observed microcirculation changes in the view of venules and capillaries distention, arteriolar wall thickening. In the spleen it has been shown a decrease in the white pulp volume, disappearing of the reactive centers in follicles. Also subcapsular edema and relative stroma volume increase has been seen frequently. The use of highly selective COG-2 inhibitor rofecoxib has not revealed statistically truthful changes in microscopic examination in comparison to the control group. That could vote for the absence of depressive action on the immune organ histomorphologic structure.

Objective: To evaluate the effectiveness of the effect of celecoxib and the combined vitamin complex of group B in comparison with meloxicam in patients with acute and chronic nonspecific lumbar pain (LP)., Material and Methods: The effectiveness of the effect on acute (44%; acute pain syndrome (APS)) and chronic (56%; chronic pain syndrome (CPS)) LP of moderate intensity (according to VAS/MPQ) (APS 5.7±2.3/2.13±0.67 points; CPS 5.2±2.8/1.47±0.61 points), the leading component of which is sensory sensations (when APS is lower than in CBS; Kr-W=6.15, p =0.04) and affective disorders in CPS ( U =117.5, p =0.04) celecoxib without (APS 25%; CPS 75%) and with the addition of Neuromultivit (APS 36%; CPS 64%) and in comparison with meloxicam (APS 100%) against the background of basic therapy in 93 patients (61.3% women and 38.7% men; average age 49.9±9. years) with nonspecific LP pain syndrome in the lower back, with a low degree of severity of motor function (MF) disorders according to the ICF (2±1 points), due to spondyloarthrosis of the lumbosacral spine., Results: It was found that celecoxib and meloxicam cause the same significant remitting decrease in the severity of APS and restoration of MF disorders in patients with APS, equally cause rare adverse events (gastropathy, increased blood pressure) in comorbid pathology. Celecoxib proved to be more effective in relieving CPS and improving MF ( p <0.05), and the combination of celecoxib with Neuromultivit caused more pronounced relief of APS and CPS, restoration of MF ( p <0.01). A steady decrease in the intensity of PS (1-2 points according to VAS), recovery of MF occurs only on the 10th-11th day of therapy ( p <0.01), with complete relief of LP by day 21 only in 60.22% of cases., Conclusion: The results of the study confirm the benefits of celecoxib in combination with a vitamin complex for the relief of CPS.

Aim: To compare the efficiency and safety of two celecoxib regimens in the short-term treatment of patients with axial spondyloarthritis (axSpA)., Subjects and Methods: Examinations were made in 40 patients with axSpA (the 2009 ASAS criteria; age, 38.5±12.1 years; 29 (72.5%) men; axSpA duration, 6.67±5.8 years; BASDAI ≥4.0), who were randomly divided into two groups: 1) 20 patients who received celecoxib 400 mg/day for 30 days; 2) 20 patients who took celecoxib 600 mg/day for 7 days, then the drug was continued at a dose of 200 mg/day for 1 month. High-sensitivity C-reactive protein (CRP) was determined; back pain was assessed using a visual analog scale; ASDAS-CRP scores were calculated at baseline (day 0) and on days 8 and 30., Results: On days 0, 8, and 30 of taking celecoxib 400 mg, the back pain scores were 6.0±3.01, 5.06±2.04, and 5.53±2.35; CRP levels, 24.13±21.46; 27.3±29.3%, and 13.1±21.3 mg/l; erythrocyte sedimentation rate (ESR), 15.25±14.36, 11.85±13.6, and 9.5±6.34 mm/h, respectively (p≥0.05 for all differences in all indicators relative to the baseline values). ASDAS was 3.34±1.02 at baseline, 2.74±1.14 on day 8, and 2.18±1.05 on day 30 (p=0.016 and p=0,000 for differences from the baseline values). In the patients using the dose de-escalation of celecoxib, the back pain scores were 4.95±1.6, 4.11±1.0, and 4.89±2.1 at baseline and on days 8 and 30, respectively (p=0.38 and p=0.065 for the differences from the baseline values); the CRP levels were 15.3±12.5, 12.1±10.8, and 7.5±4.5 mg/l, respectively (p=0.3 and p=0.001); ESR, 13.35±7.2, 15.7±11.6, and 15.16±8.9 mm/h (p≥0.05). At baseline and on days 8 and 30, ASDAS was 3.1±0.6, 2.22±0.7, and 3.47±0.56, respectively (p=0.02 and p=0.000). No differences were found in the rate of adverse events., Conclusion: Different regimens using nonsteroidal anti-inflammatory drugs demonstrated their feasibility, efficiency, and safety in AxSpA patients with high disease activity. The continuous use of celecoxib showed a gradual decrease in clinical and laboratory activity. The de-escalation dose of celecoxib achieved a permanent laboratory activity reduction and pain relief when using 600 mg celecoxib, and after reducing its dose to 200 mg/day, there was a decrease in laboratory disease activity without substantially changing the patients' functional activity. The safety of the comparable regimens was comparable.

The article presents the results of a study of clinical efficacy in the treatment of etorikoxib pain in patients with osteoarthritis of the knee and hip joints in elderly patients. The study involved 296 patients with gonarthrosis and coxarthrosis. It is shown that etoricoxib effectively relieves pain, has an advantage over other NSAIDs speed and severity of the analgesic and anti-inflammatory effect, positive impact on laboratory signs of inflammation, demonstrated good tolerability and a low incidence of side effects, does not require discontinuation of therapy.

The purpose of present study was to investigate influence of magnesium (Mg) salts (Mg L-aspartate, Mg chloride) and their combinations with pyridoxine on development of calcium-oxalate nephrolithiasis induced by sodium oxalate (3% diet weight) and celecoxib (100 mg per kg of bodyweight) according to B.C. Jeong et al. (Urol. Res. 2005; 33(6): 453-459). On 14th day of diet urinary oxalate level and crystalluria were significantly increased, creatinine clearance tended to be lower as compared to control group. Mg L-aspartate, Mg chloride and their combinations with pyridoxine, MagneB6 (Mg lactate in combination with pyridoxine) and Mg sulfate were given by intragastric intubation from 15th till 28th days of diet (50 mg Mg per kg body weight). On 28th day urinary oxalate level in rats treated with Mg salts was lower by in average 45%, creatinine clearance was increased by 19%, Ca/Mg ratio decreased by 1.5-2 times in comparison with animals fed with diet alone. Light microscopic examination of kidney sections have revealed decreased inclusion volume fraction of renal calcification in rats treated with Mg salts as to compare with untreated rats receiving sodium oxalate and celecoxib (0.3-1.0% vs. 4%). So, Mg salts prevented development of calcium-oxalate nephrolithiasis in hyperoxaluric rats. Morphological and laboratory tests showed Mg aspartate and magne B6 were more effective Mg-containing substances in comparison with other studied salts.

The study was aimed to evaluation the effect of different magnesium salts and their combinations with pyridoxine on a course of calcium-oxalate nephrolithiasis, which was modeled by adding the sodium oxalate (3% of weight of the diet) and selective cyclooxygenase-2 inhibitor celecoxib at a dose 100 mg/kg body weight to a diet for 4 weeks. Starting from the 2nd week of the experiment, the animals had received one of the following compounds: magnesium L-aspartate, magnesium chloride, and their combination with vitamin B6; magnesium sulfate and Magne B6 (magnesium lactate and vitamin B6) as comparators. 28 days after the start of the experiment, disorders progressed in the group receiving only celecoxib and oxalate-rich diet: the urine level of oxalate increased by 171% (p < 0,0001), crystalluria had increased (up to 105 crystals in 10 microml of urinary sediment, p < 0,0001), creatinine clearance decreased by 29%, compared to control (p = 0,087). Increasing calcium/magnesium and oxalate/creatinine ratios in urine by 16 and 189%, respectively, was observed. In the renal parenchyma of animals treated with sodium oxalate and celebrex, calcifications with a volume fraction of 4% were identified, whereas these changes were absent in intact animals. According to the degree of correction ofhyperoxaluria and elimination of calcium oxalate crystals, investigated salts showed similar efficacy, with the exception of magnesium sulfate, which less contributed the compensation of abnormalities in kidney and urinary. According to the data of morphological study, the volume fraction of calcifications was lowest in the groups receiving magnesium L-aspartate and Magne B6.

It is well known that cyclooxygenase-2 (COX2) plays an important role in the development of many tumors including breast cancer. Our study was concerned with evaluating the effects of the selective COX2 inhibitor, celecoxib, on mammary tumorigenesis and aging in HER2/neu transgenic mice (24). Celecoxib (celebrex) 25 mg/kg was administered 5 times a week from the age of 2 months. Twenty-four intact females were in control. Monitoring kept track of tumor detection time, size, presence of lung metastases, food and water consumption, estral function, body weight and temperature. No significant differences between the two groups were reported as far as life-span, tumor growth rate, size and number of metastases to the lung is concerned. To sum up, celecoxib treatment failed to produce any significant effect on carcinogenesis in HER2/neu transgenic mice.

We studied the anti-angiogenic properties of sutent (SU11248) and celecoxib in human endothelial cell line EA. hy 926 in vitro. Sutent 0.05-0.5 microg/ml suppressed their proliferation and migration depending on dose while celecoxib did the same at 5.0 microg/ml. We were the first to demonstrate that endothelial cell incubation was followed by increase in 5'-nucleotidase activity in the presence of sutent while celecoxib did not produce such effect. It may be suggested that elevated 5'-nucleotidase concentration at the membranes of endothelial cells might in turn contribute to the pool of extracellular adenosine to stimulate antiinflammatory effect. Our data also contribute to the knowledge about the anti-angiogenic properties of sutent and celecoxib.

Goal of the Study: To assess the pathogenetic significance of the prostaglandin level in the mucous coat of the stomach in patients with osteoarthritis who take several types of non-steroid anti-inflammatory drugs., Materials and Methods: The study of the E2 and F2alpha (prostaglandins levels in the blood and mucous coat of the stomach was conducted in 20 patients with stomach ulcer, 15 patients with osteoarthritis taking diclofenac and 16 patients taking celecoxib., Results: It has been shown that the E2 prostaglandin level decreases both in the blood and in the mucous coat of the stomach in patients with stomach ulcer. If non-steroid anti-inflammatory drugs are taken, the E2 prostaglandin level in the mucous coat of the stomach decreases even if there are no erosive-ulcerous lesions. If celecoxib is taken, the changes in the prostaglandin E2 and F2beta level in the mucous coat of the stomach are less marked. Patients with the low content of E2 prostaglandin in the mucous coat of the stomach develop gastropathies more frequently even before non-steroid anti-inflammatory drugs are taken., Conclusion: Reduction of the basal prostaglandin secretion in the mucous coat of the stomach is a risk factor of non-steroid anti-inflammatory drugs gastropathy appearance. The use of selective COX-2 inhibitors makes it possible to reduce the risk of gastropathy appearance in this group of patients.

In the saluresis, water and osmotic diuresis were indicating an increase of prostaglandin E2 excretion and a correlation between this index and diuresis. Unselective blockade of cyclooxygenase by diclofenac-natrium leads to a decrease of diuresis in the observed types of urine-production in rats. Inhibition of inducible cyclooxygenase by celebrex didn't change the value of diuresis after water load or administration of osmotic agent, but decreased the diuretic effect of furosemide.

Objective: To determine whether it is possible to continue the anti-inflammatory NSAID therapy of osteoarthrosis patients with the NSAID-induced duodenal ulcer. The results of the treatment of 38 patients with osteoarthrosis of II-III degrees in which the NSAID treatment was complicated with duodenal ulcers were analyzed. The treatment of 20 osteoarthrosis patients was carried out with the help of Celecoxib while 18 patients were on Tramadol as an analgesic therapy against a standard antiulcer therapy. The efficacy of osteoarthrosis treatment was assessed based on the pain syndrome dynamics by the VAS and functional Lequin test; the efficacy of duodenal ulcer treatment was assessed on the basis of clinical signs dynamics under EGD (esophagogastroduodenoscopy). A clinical remission (the endoscopy confirmed the healing of the ulcerous affection) was achieved in 19 Celecoxib patients with duodenal ulcer and osteoarthrosis, and 18 Tramadol patients with osteoarthrosis and duodenal ulcer against a standard antiulcer therapy. Celecoxib can serve as a drug of choice for continuing the anti-inflammatory and analgesic therapy in patients with osteoarthrosis and NSAID gastropathy.