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Cyclooxygenase inhibitors: any reservations?
Author(s) -
Penglis P. S.,
James M. J.,
Cleland L. G.
Publication year - 2001
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1046/j.1445-5994.2001.00002.x
Subject(s) - medicine , rofecoxib , celecoxib , cyclooxygenase , adverse effect , pharmacology , valdecoxib , nabumetone , enzyme , nonsteroidal , biochemistry , chemistry
The discovery of two cyclooxygenase isozymes, constitutive COX‐1 and inducible COX‐2, has resulted in the rapid development of selective inhibitors of COX‐2, such as celecoxib and rofecoxib. Compared with traditional non‐steroidal anti‐inflammatory drug agents, use of COX‐2 selective inhibitors is associated with decreased incidence of adverse gastric events as a result of minimal inhibition of gastroprotective COX‐1, but with equivalent anti‐inflammatory benefit through inhibition of COX‐2. However, there is evidence to suggest that the ‘COX‐1 = constitutive, COX‐2 = inflammatory’ paradigm is less distinct than originally proposed. Futhermore, selective COX‐2 inhibitors may have other consequences as a result of the change in the eicosanoid profile. Thus, despite the relatively safe gastrointestinal profile, vigilant post‐marketing surveillance for other adverse effects is required. (Intern Med J 2001; 31: 37–41.