title: Treatment of rheumatoid arthritis and osteoarthritis with COX-2-selective inhibitors: a managed care perspective.
abstract: The development of cyclooxygenase (COX)-2-selective inhibitors represents a major advance in the management of chronic pain and inflammation that may satisfy an unmet medical need for agents with improved gastrointestinal (GI) safety. This article is a review of the pharmacology, clinical efficacy, and safety of COX-2-selective inhibitors in the managed healthcare setting. The efficacy of COX-2-selective inhibitors in relieving chronic pain from osteoarthritis and rheumatoid arthritis is comparable to that of traditional nonsteroidal anti-inflammatory drugs (NSAIDs). However, the occurrence of GI complications may be less frequent in patients who receive COX-2-selective inhibitors than in patients receiving traditional NSAIDs. Thus, the use of COX-2-selective inhibitors for the management of chronic pain may reduce overall costs and provide an alternative with an improved safety profile compared with traditional NSAIDs.
authors.affiliation: University of Maryland School of Medicine, Baltimore, USA.
authors.forename: Marc C
authors.initials: MC
authors.lastname: Hochberg
mesh_terms: D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D000068579:Celecoxib; D003362:Cost-Benefit Analysis; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007527:Isoenzymes / Q000187:drug effects; D007783:Lactones / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008329:Managed Care Programs; D008565:Membrane Proteins; D010003:Osteoarthritis / Q000188:drug therapy*; D011451:Prostaglandin-Endoperoxide Synthases / Q000187:drug effects; D011720:Pyrazoles; D019057:Quality-Adjusted Life Years; D013449:Sulfonamides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D013450:Sulfones; D014481:United States
chemical_list: D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D007783:Lactones; D008565:Membrane Proteins; D011720:Pyrazoles; D013449:Sulfonamides; D013450:Sulfones; C116926:rofecoxib; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases; D000068579:Celecoxib