Acute and chronic use of non-steroidal anti-inflammatory drugs can increase intestinal permeability.
Rofecoxibselectively inhibits cyclooxygenase 2 (COX-2).
Dr G. Sigthorsson and colleagues assessed the potential for rofecoxib to affect the intestine adversely, in comparison with placebo and indomethacin.
They performed a four-period crossover trial in 39 healthy subjects (aged 24-30 years), to assess intestinal permeability before and after seven days of dosing.
Permeability was measured by the urinary ratio of (51)CrEDTA)/L-rhamnose (5-hour collection).
"Increased intestinal permeability is a prerequisite to NSAID enteropathy."
Dr Ingvar Bjarnason.
Indomethacin 50 mg t.i.d. produced greater increases in intestinal permeability compared with placebo or rofecoxib (25 or 50 mg). Rofecoxib was not significantly different from placebo.
In this study, dosing for a week with indomethacin 50 mg t.i.d. significantly increased intestinal permeability compared with placebo, but dosing with rofecoxib 25 mg or 50 mg daily did not.
The absence of a significant effect of rofecoxib on intestinal permeability at doses at least twice those recommended to treat osteoarthritis, was consistent with other studies that have demonstrated little or no injury to the gastrointestinal mucosa associated with rofecoxib therapy.