Nonsteroidal antiinflammatory drugs: past, present and future.
Currently available NSAIDs represent a heterogeneous group of therapeutic agents characterized by a variable benefit/risk profile. The development of a new class of selective COX-2 inhibitors, the coxibs, has contributed importantly to clarifying the discrete roles of COX-2 vs. COX-1 inhibition in different aspects of NSAID-related efficacy and safety. Cardiovascular toxicity has emerged as a previously unrecognized, mechanism-based effect of COX-2 inhibitors. Lessons learned from the many facets of the coxib failure story may help guiding the successful development of a new class of safer NSAIDs, targeting mediators unrelated to arachidonic acid metabolism or molecular targets downstream of COX-isozymes.
Patrono
Carlo
C
Department of Pharmacology, Catholic University School of Medicine, Rome, Italy. carlo.patrono@rm.unicatt.it
Rocca
Bianca
B
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000266:history / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000139:chemically induced*; D052246:Cyclooxygenase 2 Inhibitors / Q000009:adverse effects* / Q000266:history* / Q000627:therapeutic use; D005767:Gastrointestinal Diseases / Q000139:chemically induced*; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D018570:Risk Assessment
D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors