[Non-steroidal anti-inflammatory drugs and cyclooxygenase-2-specific inhibitors].
The discovery of two isoenzymes of cyclooxygenase--COX-1 and COX-2--in the late eighties was followed by an intensive looking for drugs, which inhibit specifically COX-2 and have no influence on COX-1. After some years of trial and error it is now possible to measure the inhibition-capacity--e.g. of Rofecoxib, Celecoxib and all the conventional NSAIDs--in a human blood assay. New insights into localisation, expression and physiological function of COX-2 followed. We now are able to differentiate between "conventional" NSAIDs and COX-2 specific inhibitors (CSI, COXIBS), as a new class of substances. CSI firstly inhibit COX-1/COX-2 to a different extent and in a different manner. Secondly they have a different profile concerning unwanted--especially gastrointestinal--side effects. Further experiences and investigations have to confirm and establish this positive risk/benefit ratio.
Miehle
W
W
Rheumazentrum der Reha-Klinik Wendelstein der BfA, AHB, Bad Aibling, Deutschland.
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000209:etiology; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D007527:Isoenzymes / Q000037:antagonists & inhibitors* / Q000494:pharmacology*; D011451:Prostaglandin-Endoperoxide Synthases / Q000494:pharmacology*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D051546:Cyclooxygenase 2; D011451:Prostaglandin-Endoperoxide Synthases