[Coxibs, which real therapeutic advance?: Recent pharmacoepidemiological data].
Therapeutic advance is defined by an improvement in effectiveness, safety and/or convenience. In this article, these three criteria were applied to currently marketed coxibs (celecoxib, rofecoxib), using data from clinical trials and pharmacoepidemiological studies. Risk of adverse drug reactions to coxibs, as evaluated by clinical trials, differs from that observed in real medical practice. Rofecoxib and celecoxib exhibit the same profile of adverse drug reactions as the other classical nonsteroidal anti-inflammatory drugs. Coxibs are currently prescribed and too often used outside the studied and approved indications, which clearly increases their cost (already high for society). Currently marketed coxibs do not appear to meet the previously defined criteria for therapeutic advance.
Montastruc
Jean-Louis
JL
Service de Pharmacologie Clinique du Centre Hospitalier Universitaire de Toulouse, France. montastruc@cict.fr
Lapeyre-Mestre
Maryse
M
Gony
Mireille
M
Lugardon
Stephanie
S
Bagheri
Haleh
H
D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000453:epidemiology; D000068579:Celecoxib; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D007527:Isoenzymes / Q000378:metabolism*; D007783:Lactones / Q000009:adverse effects / Q000627:therapeutic use; D008565:Membrane Proteins; D017891:Pharmacoepidemiology; D011451:Prostaglandin-Endoperoxide Synthases / Q000378:metabolism*; D011720:Pyrazoles; D018570:Risk Assessment; D013449:Sulfonamides / Q000009:adverse effects / Q000627:therapeutic use; D013450:Sulfones
D000894:Anti-Inflammatory Agents, Non-Steroidal; 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
Coxibs, quel réel progrès thérapeutique?: données pharmacoépidémiologiques récentes.