COX-2 Specific Inhibitor and Cognitive Function: a Pilot Study

Choi, Yeon Soo; Oh, Seung Il; Lee, Jang Whan; Kim, Tae Hwan; Jun, Jae Bum; Jung, Sungsoo; Yoo, Dae Hyun; Bae, Sang Cheol

Abstract

OBJECTIVE
New nonsteroidal anti-inflammatory drugs (NSAIDs) with highly selective cyclooxygenase-2 (COX-2) inhibition afford protection against gastropathy, but their acute and long-term effects on the central nervous system are unclear. Our aim was to investigate the influence of COX-2 specific inhibitor (celecoxib) on cognitive function.
METHODS
Within the context of a randomized controlled parallel trial of NSAIDs for osteoarthitis (OA), we performed a battery of neuropsychological tests in consecutive 10 osteoarthritis patients with celecoxib (200 mg/day) and 13 osteoarthritis patients with diclofenac (100 mg/day) before and after 4 weeks by clinical psychologists who were not involoved in the study and unaware of study protocols and treatment allocation. The tests were performed randomly in sequence in order to minimize learning effect. The examed cognitive domains included memory, reasoning/problem solving, simple and complex attention, visual-spatial processing, and psychomotor speed.
RESULTS
Demographic characteristcs (age, sex, disease duration, functional status measured by patient's and physician's global assessment and KWOMAC, CES depression score, education level) were not significantly different between both treatment groups. In all cognitive domains, we did not find out significant cognitive decline before and after treatments either with celecoxib or diclofenac. There was no difference in the change of cognitive function between both treatment groups.
CONCLUSION
The short-term use of COX-2 specific inhibitor as well as conventional NSAID may not impair cognitive function. The long-term follow up study using large number of patients is in progress.