Effects of celecoxib on hematoma and edema volumes in primary intracerebral hemorrhage: A multicenter randomized controlled trial

Background and purpose: We investigated the effect of celecoxib, a selective inhibitor of cyclo-oxygenase 2, in patients with intracerebral hemorrhage (ICH). Methods: We conducted a multicenter, randomized, controlled, and open with blinded end-point trial of 44 Korean patients 18years or older with ICH within 24h of onset. The intervention group (n=20) received celecoxib (400mg twice a day) for 14days. The control group (n=24) received the standard medical treatment for ICH. The primary end-point was the number of patients with a change in the volume of perihematomal edema (PHE) from the 1st to the 7th±1day (cut-off value, 20%). Results: The time from onset to computed tomography scan slightly differed between groups (177±160min for control vs. 297±305min for the celecoxib group; P=0.10). In the primary end-point analysis using cut-off values, there was a significant shift to reduced expansion of PHE in the celecoxib group (P=0.005). With respect to the secondary end-points, there was also a significant shift to reduced expansion of ICH in the celecoxib group (P=0.046). In addition, the expansion rate of PHE at follow-up tended to be higher in the control group than in the celecoxib group (90.6±91.7% vs. 44.4±64.9%; P=0.058). Conclusions: In our small, pilot trial, administration of celecoxib in the acute stage of ICH was associated with a smaller expansion of PHE than that observed in controls.