title: COX-2 inhibition and thrombotic tendency: a need for surveillance.
abstract: Cyclooxygenase-2 (COX-2) inhibitors belong to a new class of drugs which have anti-inflammatory efficacy similar to that of traditional non-steroidal anti-inflammatory drugs (NSAIDs), but are associated with a reduced incidence of adverse upper gastrointestinal events. Biochemical evidence that COX-2 inhibitors could promote or exacerbate a tendency to thrombosis is supported by recent results from clinical trials and case reports. Two agents in this class, celecoxib and rofecoxib, have been listed on the Pharmaceutical Benefits Scheme (PBS) for very broad indications in chronic arthropathies, suggesting that they will move into widespread community use. It is important to canvass the possibility that use of these agents could be associated with thrombotic events.
authors.affiliation: Rheumatology Unit, Royal Adelaide Hospital, SA. Iceland@mail.rah.sa.gov.au
authors.forename: L G
authors.initials: LG
authors.lastname: Cleland
authors.forename: M J
authors.initials: MJ
authors.lastname: James
authors.forename: L K
authors.initials: LK
authors.lastname: Stamp
authors.forename: P S
authors.initials: PS
authors.lastname: Penglis
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D001241:Aspirin / Q000009:adverse effects* / Q000627:therapeutic use; D000068579:Celecoxib; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006801:Humans; D007783:Lactones / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D011720:Pyrazoles; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013449:Sulfonamides / Q000009:adverse effects* / Q000627:therapeutic use; D013450:Sulfones; D020246:Venous Thrombosis / Q000139:chemically induced*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D016861:Cyclooxygenase Inhibitors; D007783:Lactones; D011720:Pyrazoles; D013449:Sulfonamides; D013450:Sulfones; C116926:rofecoxib; D000068579:Celecoxib; D001241:Aspirin