Does Celecoxib Effectively Lower CRP Levels in Patients?

Q: Does Celecoxib Effectively Lower CRP Levels in Patients?

Hello, thank you for your question. <br>Here are my answers： 1) Does Secukinumab have no effect on lowering CRP? --> Yes, in principle, it has no effect or a poor effect. <br>2) If not, is the reason the same as why Secukinumab does not lower ESR? --> Yes, the reasons are the sam

Can Xeljanz reduce CRP levels?

Hello Dr.
Gao: I previously asked you a question (number 188046), and the complete inquiry and response are attached below.
I would like to ask you another question: 1) Does sulfasalazine not have an effect on lowering CRP? 2) If not, is the reason the same as why sulfasalazine does not lower ESR? Thank you, doctor.
The question and response for number 188046 are as follows: ------- Hello doctor, I am a patient with ankylosing spondylitis and have been ill for one year.
During this year, I have been taking sulfasalazine.
Although my buttock pain has subsided and my CRP is normal, my ESR has not shown significant improvement during the year of treatment (it fluctuates between 36-54, with only 1-2 instances dropping to around 18).
I would like to ask the doctor: 1) Although sulfasalazine is an anti-inflammatory and analgesic medication, it does not lower ESR, correct? 2) If that is the case, since sulfasalazine claims to have anti-inflammatory effects, why is it unable to lower the inflammatory marker ESR? Dr.
Gao's response was as follows: 1) Although sulfasalazine is an anti-inflammatory and analgesic medication, it does not lower ESR, correct? --> I believe that using anti-inflammatory and analgesic medications to lower ESR is ineffective.
2) If that is the case, since sulfasalazine claims to have anti-inflammatory effects, why is it unable to lower the inflammatory marker ESR? --> There are many factors that affect ESR; it is a marker of systemic inflammation.
The anti-inflammatory effects of analgesics only control one of the mechanisms that cause inflammatory pain, so they are less likely to lower ESR.
However, ESR is just one indicator; it is more important to assess the overall condition of the patient regarding inflammation and pain, rather than focusing solely on ESR.

Hao, 50~59 year old female. Ask Date: 2023/02/08

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your question.
Here are my answers: 1) Does Secukinumab have no effect on lowering CRP? --> Yes, in principle, it has no effect or a poor effect.
2) If not, is the reason the same as why Secukinumab does not lower ESR? --> Yes, the reasons are the same.
However, Secukinumab can relieve pain, which can improve quality of life and increase patients' willingness to exercise, which is very important for ankylosing spondylitis.
This aspect cannot be determined solely by whether it lowers CRP or ESR.
Therefore, it is advisable to conduct a comprehensive assessment when considering which medication is better, and it is also recommended not to focus solely on CRP and ESR.
Department of Allergy, Immunology, and Rheumatology, Changhua Hospital, Ministry of Health and Welfare.
We care about you.

Reply Date: 2023/02/08

More Info

Celecoxib, commonly known as Celebrex, is a non-steroidal anti-inflammatory drug (NSAID) that is primarily used to relieve pain and inflammation in conditions such as arthritis. The question of whether Celecoxib effectively lowers C-reactive protein (CRP) levels in patients, particularly those with inflammatory conditions like ankylosing spondylitis, is an important one.

To address your first question, while Celecoxib is indeed an anti-inflammatory medication, its effect on CRP levels can vary among individuals. CRP is a protein produced by the liver in response to inflammation, and its levels can be elevated in various inflammatory conditions. Studies have shown that while Celecoxib can reduce pain and inflammation, it does not consistently lead to a significant decrease in CRP levels. This is partly because CRP is a marker of systemic inflammation, and its levels can be influenced by multiple factors beyond just the inflammatory pathways that Celecoxib targets.

Regarding your second question, the relationship between Celecoxib's effect on CRP and its effect on erythrocyte sedimentation rate (ESR) is indeed similar. ESR is another marker of inflammation, and like CRP, it can be influenced by a variety of factors, including the presence of other underlying conditions, the patient's overall health, and even the timing of the blood test in relation to medication dosing. Celecoxib may not effectively lower ESR levels for the same reasons it does not consistently lower CRP levels. The mechanisms of inflammation are complex, and while Celecoxib can inhibit certain inflammatory pathways, it may not address all the factors that contribute to elevated ESR.

In clinical practice, it is essential to interpret CRP and ESR levels in the context of the patient's overall clinical picture. A patient may experience significant symptom relief and improved quality of life while still having elevated inflammatory markers. This is why healthcare providers often emphasize the importance of a comprehensive evaluation rather than relying solely on laboratory values to assess treatment efficacy.

Moreover, the variability in response to Celecoxib among patients can be attributed to genetic factors, the specific inflammatory condition being treated, and the presence of comorbidities. Some patients may respond well to Celecoxib, experiencing both pain relief and a decrease in inflammatory markers, while others may find that their CRP and ESR levels remain unchanged despite symptomatic improvement.

In conclusion, while Celecoxib is effective in managing pain and inflammation, its impact on CRP and ESR levels may not be as pronounced or consistent. It is crucial for patients to have open discussions with their healthcare providers about their treatment goals, the significance of inflammatory markers, and the overall management of their condition. Regular monitoring and a holistic approach to treatment can help ensure that patients receive the best possible care tailored to their individual needs.

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