title: Dose-dependent inhibition of platelet cyclooxygenase-1 and monocyte cyclooxygenase-2 by meloxicam in healthy subjects.
abstract: We evaluated whether therapeutic blood levels of meloxicam are associated with selective inhibition of monocyte cyclooxygenase (COX)-2 in vitro and ex vivo. Concentration-response curves for the inhibition of monocyte COX-2 and platelet COX-1 were obtained in vitro after the incubation of meloxicam with whole blood samples. Moreover, 11 healthy volunteers received placebo or 7.5 or 15 mg/day meloxicam, each treatment for 7 consecutive days, according to a randomized, double-blind, crossover design. Before dosing and 24 h after the seventh dose of each regimen, heparinized whole blood samples were incubated with lipopolysaccharide (10 microgram/ml) for 24 h at 37 degrees C, and prostaglandin E2 was measured in plasma as an index of monocyte COX-2 activity. The production of thromboxane B2 in whole blood allowed to clot at 37 degrees C for 60 min was assessed as an index of platelet COX-1 activity. The administration of placebo did not significantly affect plasma prostaglandin E2 (21. 3 +/- 7.5 versus 19.1 +/- 4 ng/ml, mean +/- S.D., n = 11) or serum thromboxane B2 (426 +/- 167 versus 425 +/- 150 ng/ml) levels. In contrast, the administration of 7.5 and 15 mg of meloxicam caused dose-dependent reductions in monocyte COX-2 activity by 51% and 70%, respectively, and in platelet COX-1 activity by 25% and 35%, respectively. Although the IC50 value of meloxicam for inhibition of COX-1 was 10-fold higher than the IC50 value of COX-2 in vitro, this biochemical selectivity was inadequate to clearly separate the effects of meloxicam on the two isozymes after oral dosing as a function of the daily dose and interindividual variation in steady-state plasma levels.
authors.affiliation: Department of Medicine and Aging, Division of Pharmacology, University of Chieti "G. D'Annunzio" School of Medicine, Chieti, Italy.
authors.forename: M R
authors.initials: MR
authors.lastname: Panara
authors.forename: G
authors.initials: G
authors.lastname: Renda
authors.forename: M G
authors.initials: MG
authors.lastname: Sciulli
authors.forename: G
authors.initials: G
authors.lastname: Santini
authors.forename: M
authors.initials: M
authors.lastname: Di Giamberardino
authors.forename: M T
authors.initials: MT
authors.lastname: Rotondo
authors.forename: S
authors.initials: S
authors.lastname: Tacconelli
authors.forename: F
authors.initials: F
authors.lastname: Seta
authors.forename: C
authors.initials: C
authors.lastname: Patrono
authors.forename: P
authors.initials: P
authors.lastname: Patrignani
mesh_terms: D000328:Adult; D001792:Blood Platelets / Q000187:drug effects / Q000201:enzymology*; D018592:Cross-Over Studies; D051545:Cyclooxygenase 1; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000097:blood / Q000494:pharmacology*; D015232:Dinoprostone / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D007527:Isoenzymes / Q000097:blood / Q000378:metabolism*; D008297:Male; D000077239:Meloxicam; D008565:Membrane Proteins; D009000:Monocytes / Q000187:drug effects / Q000201:enzymology*; D011451:Prostaglandin-Endoperoxide Synthases / Q000097:blood / Q000378:metabolism*; D013843:Thiazines / Q000097:blood / Q000494:pharmacology*; D013844:Thiazoles / Q000097:blood / Q000494:pharmacology*; D013929:Thromboxane B2 / Q000097:blood
chemical_list: D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D008565:Membrane Proteins; D013843:Thiazines; D013844:Thiazoles; D013929:Thromboxane B2; D051545:Cyclooxygenase 1; D051546:Cyclooxygenase 2; C496511:PTGS1 protein, human; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases; D015232:Dinoprostone; D000077239:Meloxicam