It's an interesting question that I don't remember being asked here before. I turned up the following:
www.ncbi.nlm.nih.gov said...
4. Selective COX2 Inhibitors and IBD
Selective COX2 inhibitors cause less GI toxicity compared to conventional NSAIDS. To date, studies on the use of selective COX2 inhibitors in IBD have yielded mixed results. Mahadevan et al. [29] evaluated 27 patients with CD, UC and pouchitis receiving Rofecoxib or Celecoxib. Treatment was shown to be both beneficial and safe. A large double blind placebo controlled trial by Sandborn et al. [30] of 222 UC patients in remission with arthritis or arthralgias demonstrated that up to two weeks treatment with Celecoxib did not result in a higher relapse rate than placebo. Another multicenter double blind placebo controlled trail by Miedeny et al. [31] included 146 patients with IBD receiving either Etoricoxib or placebo for three months. Treatment was beneficial and safe and was not associated with disease flare. Another open label trial by Reinisch [32] demonstrated the efficacy and safety profile of Rofecoxib in similar patients.
In contrast, several case reports of exacerbations in patients with IBD receiving COX2 inhibitors have been reported [33,34]. Bioncone et al. [16] evaluated the safety and efficacy of COX2 inhibitors in an open label study. Rofecoxib controlled the arthralgias in two thirds of the patients, however side effects requiring discontinuation of the medication were observed in one fifth of the patients with IBD. These included abdominal pain, diarrhea, bloody stool and heart burn. Matuk et al. [32] evaluated the safety and toxicity of Celecoxib and Rofecoxib in 33 patients with IBD. All patients experienced a flare of their disease within 6 weeks of initiating COX2 therapy and 38% of them had resolution of their symptoms upon discontinuation of the treatment. Finally, a recent meta-analysis [35], on the use of COX2 inhibitors in IBD patients concluded that there is insufficient data to determine the impact of COX2 inhibitors on IBD exacerbations. These mixed finding suggest that further evaluation of the use of COX2 selective inhibitors in patients with IBD is required. Table 2 summarizes studies on the effect of NSAIDS on IBD.
5. Summary and Conclusions
In conclusion, to date, the available data in the literature on the effects of NSAIDS on IBD activity is inconclusive. It remains unclear whether NSAIDS and COX2 selective inhibitors indeed cause flares of IBD and whether COX2 inhibitors are safer than conventional NSAIDS. There is some evidence to suggest that short term usage of COX2 selective inhibitors is safe and beneficial in patients with IBD. Concomitant use of NSAIDS or COX2 inhibitors and steroids in patients with IBD warrants special consideration and careful monitoring due to the potentially increased cardiovascular and UGI toxicity, especially in older patients. Further research and controlled future clinical trials will help clear some of these topics.
Source:
/www.ncbi.nlm.nih.gov/pmc/articles/PMC4034022/