title: Efficacy and Safety of COX-2 Inhibitors in the Clinical Management of Arthritis: Mini Review.
abstract: In the clinical management of arthritis, the choice of nonsteroidal anti inflammatory drug (NSAID) remains confusing and controversial. A common practice on the choice of NSAID in clinical management of arthritis is the risk benefit ratio. The main objective of this review is to addresses the main arguments for the pharmacological and clinical use of COX-2 inhibitors in relation to nonselective NSAIDs for the clinical management of arthritis. This review concluded that, both NSAIDs and COX-2 inhibitors are equally effective and are associated with increased risk of GI, renal, and CV, adverse effects. Complete understanding of the patient's comorbid conditions and concomitant medications, coupled with precise monitoring during the treatment, may help to decrease the threat of adverse effects induced by nonselective NSAIDs and selective COX-2 inhibitors.
authors.affiliation: Medical Writing Group, Accenture Pharmaceutical Services, Karnataka, Bangalore 560072, India.
authors.forename: Sam T
authors.initials: ST
authors.lastname: Mathew
authors.forename: Gayathri
authors.initials: G
authors.lastname: Devi S
authors.forename: V V
authors.initials: VV
authors.lastname: Prasanth
authors.forename: B
authors.initials: B
authors.lastname: Vinod
references.citation: N Engl J Med. 1992 Sep 10;327(11):749-54
references.pmid: 1501650
references.citation: Lancet. 1994 Apr 30;343(8905):1075-8
references.pmid: 7909103
references.citation: Atherosclerosis. 2004 Dec;177(2):235-43
references.pmid: 15530895
references.citation: Ann Rheum Dis. 2003 Jun;62(6):501-9
references.pmid: 12759283
references.citation: Lancet. 2004 Aug 21-27;364(9435):665-74
references.pmid: 15325831
references.citation: Curr Med Res Opin. 2003;19(8):725-36
references.pmid: 14687444
references.citation: J Pharmacol Exp Ther. 2002 Feb;300(2):367-75
references.pmid: 11805193
references.citation: N Engl J Med. 2000 Nov 23;343(21):1520-8, 2 p following 1528
references.pmid: 11087881
references.citation: Curr Med Chem. 2002 May;9(10):1033-43
references.pmid: 12733982
references.citation: Aliment Pharmacol Ther. 2003 Feb;17(3):321-32
references.pmid: 12562444
references.citation: Rheumatology (Oxford). 1999 May;38 Suppl 1:33-8
references.pmid: 10369404
references.citation: Semin Arthritis Rheum. 2002 Dec;32(3 Suppl 1):4-14
references.pmid: 12528069
references.citation: Arch Intern Med. 1998 Jan 12;158(1):33-9
references.pmid: 9437376
references.citation: Am J Med. 2001 Feb 19;110  Suppl 3A:28S-32S
references.pmid: 11173047
references.citation: Proc Natl Acad Sci U S A. 1994 Apr 12;91(8):3228-32
references.pmid: 8159730
references.citation: Am J Cardiol. 2002 Mar 21;89(6A):3D-9D
references.pmid: 11909555
references.citation: Fundam Clin Pharmacol. 2003 Jun;17(3):301-13
references.pmid: 12803569
references.citation: BMJ. 2002 Sep 21;325(7365):619
references.pmid: 12242171
references.citation: Am J Kidney Dis. 2001 Dec;38(6):1145-57
references.pmid: 11728945
references.citation: BMJ. 2006 Jun 3;332(7553):1302-8
references.pmid: 16740558
references.citation: J Rheumatol Suppl. 1997 Feb;47:23-31
references.pmid: 9035017
references.citation: BMJ. 2001 Nov 24;323(7323):1236-9
references.pmid: 11719417
references.citation: N Engl J Med. 1999 Jun 17;340(24):1888-99
references.pmid: 10369853
references.citation: Semin Arthritis Rheum. 1997 Jun;26(6 Suppl 1):11-5
references.pmid: 9219314
references.citation: J Clin Invest. 2006 Jan;116(1):4-15
references.pmid: 16395396
references.citation: J Physiol Pharmacol. 1999 Dec;50(4):661-7
references.pmid: 10639016
references.citation: Clin Cornerstone. 2001;3(5):50-60
references.pmid: 11464731
references.citation: Lancet. 1994 Mar 26;343(8900):769-72
references.pmid: 7907735
references.citation: Am J Cardiol. 2002 Mar 21;89(6A):10D-17D
references.pmid: 11909556
references.citation: Ann Rheum Dis. 2003 Dec;62(12):1145-55
references.pmid: 14644851
references.citation: Lancet. 1999 Jan 23;353(9149):307-14
references.pmid: 9929039
references.citation: Eur J Rheumatol Inflamm. 1994;14(2):29-38
references.pmid: 7744131
references.citation: Pain. 2004 Oct;111(3):286-296
references.pmid: 15363872
references.citation: Circulation. 2004 May 4;109(17):2068-73
references.pmid: 15096449
references.citation: Am J Med. 1999 Dec 13;107(6A):27S-35S; discussion 35S-36S
references.pmid: 10628591
references.citation: J Rheumatol Suppl. 1997 Feb;47:17-22
references.pmid: 9035016
references.citation: Nat New Biol. 1971 Jun 23;231(25):232-5
references.pmid: 5284360
references.citation: JAMA. 2000 Sep 13;284(10):1247-55
references.pmid: 10979111
references.citation: Semin Arthritis Rheum. 2002 Dec;32(3 Suppl 1):25-32
references.pmid: 12528071
references.citation: Cochrane Database Syst Rev. 2005 Jan 25;(1):CD005115
references.pmid: 15654705
references.citation: Arthritis Rheum. 2000 Sep;43(9):1905-15
references.pmid: 11014340
references.citation: Aliment Pharmacol Ther. 2006 Sep 1;24(5):751-67
references.pmid: 16918879
references.citation: J Rheumatol. 2001 Nov;28(11):2375-82
references.pmid: 11708405
references.citation: Cochrane Database Syst Rev. 2002;(4):CD003831
references.pmid: 12519610
references.citation: Rheumatology (Oxford). 2009 Apr;48(4):425-32
references.pmid: 19223284