Cyclooxygenase-2: a major therapeutic advance?
The introduction of the highly selective cyclooxygenase-2 (COX-2) inhibitors (Coxibs) has resulted in the greatest new drug use ever. The hypothesis on which these drugs were developed was that COX-2-specific inhibitors would retain the advantageous aspects but restrict the deleterious effects of conventional nonsteroidal anti-inflammatory drugs (NSAIDs). Current practice and evidence suggests that bleeding from the gastrointestinal tract is reduced to the level of placebo and that dyspepsia persists, and in other areas (particularly renal side effects), COX-2-specific inhibitors still have classic NSAID problems.
Emery
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Rheumatology and Rehabilitation Research Unit, Leeds University, Leeds, United Kingdom.
D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D004415:Dyspepsia / Q000139:chemically induced; D005753:Gastric Mucosa / Q000187:drug effects*; D005773:Gastroscopy; D006801:Humans; D007527:Isoenzymes / Q000037:antagonists & inhibitors*; D007668:Kidney / Q000187:drug effects; D008565:Membrane Proteins; D010003:Osteoarthritis / Q000188:drug therapy; D011451:Prostaglandin-Endoperoxide Synthases; D012016:Reference Values; D016896:Treatment Outcome
D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D008565:Membrane Proteins; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases