Cyclooxygenase-2 specific inhibitors in the treatment of dysmenorrhea.
Introduction of specific cyclooxygenase (COX)-2 inhibitors holds the promise of improved treatment for inflammatory processes without the gastrointestinal effects associated with the conventional non-selective nonsteroidal anti-inflammatory drugs (NS-NSAID), which inhibit both COX-1 and COX-2 activity. Dysmenorrhea is a common inflammatory process that affects many adolescent girls, and is the leading cause of recurrent short-term school or work absenteeism among female adolescents and young adults. In vitro studies have shown that the selective COX-2 inhibitors have a potent tocolytic effect. In vivo studies have found the specific COX-2 inhibitors rofecoxib (Vioxx) and valdecoxib (Bextra) effective in treatment of primary dysmenorrhea in women >or=18 years. Adolescents suffering from dysmenorrhea with a prior history of peptic ulcer, or with a history of NS-NSAID gastrointestinal adverse effects, or who require high doses of NS-NSAID during the menstrual period, as well as adolescents with coagulation deficiencies, may benefit from the use of a specific COX-2 inhibitor. Studies are warranted to explore whether the specific COX-2 inhibitors are effective in treating dysmenorrhea in the adolescent age group.
Harel
Zeev
Z
Hasbro Children's Hospital, and Department of Pediatrics, Brown University, Providence, Rhode Island 02903, USA. ZHarel@Lifespan.org
D000293:Adolescent; D000328:Adult; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology / Q000627:therapeutic use*; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D004412:Dysmenorrhea / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000037:antagonists & inhibitors*; D008565:Membrane Proteins; D011451:Prostaglandin-Endoperoxide Synthases; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D008565:Membrane Proteins; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases