How does Celebrex work?

NSAIDs target an enzyme called cyclooxegenase that is responsible for much inflammation behind pain. But it turned out there are two types of this enzyme. Cox-2 was behind the inflammation, while cox-1 actually protects the stomach lining. Unfortunately, NSAIDs target both which often can result in ulcers.

The mechanism of action of Celebrex™ is believed to be due to inhibition of prostaglandin synthesis, primarily via inhibition of cyclooxygenase-2 (COX-2), and at therapeutic concentrations in humans, Celebrex™ does not inhibit the cyclooxygenase-1 (COX-1) isoenzyme.

The theory was that if scientists could develop a more specific drug that targeted just cox-2, it would alleviate pain and inflammation while not effecting the delicate lining of the stomach.

In studies of about 13,000 patients, it appeared to work almost as well as prescription-strength naproxen in-patients with osteoarthritis. In rheumatoid arthritis sufferers, it appeared to work almost as well as another popular NSAID, diclofenac.

Clinical testing involving some 4,500 endoscopies -- probing a tube into patients' stomachs to see if ulcers were forming even before they experienced symptoms. Some 25 percent to 40 percent of patients taking ibuprofen or naproxen showed these mini-ulcers, vs. 5 percent to 10 percent of Celebrex patients.