Clinical Potential of Cyclo-Oxygenase-2 Inhibitors
作者:
Jaime A. Oviedo,
M. Michael Wolfe,
期刊:
BioDrugs
(ADIS Available online 2001)
卷期:
Volume 15,
issue 9
页码: 563-572
ISSN:1173-8804
年代: 2001
出版商: ADIS
关键词: Celecoxib, therapeutic use;Colorectal cancer, treatment;Cyclo oxygenase 2 inhibitors, adverse reactions;Cyclo oxygenase 2 inhibitors, therapeutic use;Gastrointestinal disorders, drug-induced;Rheumatic disorders, treatment;Rofecoxib, therapeutic use
数据来源: ADIS
摘要:
On the basis of their reduced potential to cause injury to the gastroduodenal mucosa, cyclo-oxygenase (COX)-2-selective inhibitors were developed and marketed as a safer alternative to traditional nonsteroidal anti-inflammatory drugs (NSAIDs). This manuscript reviews the major steps leading to the introduction of COX-2-selective inhibitors into clinical practice, from the identification of the COX isoenzymes to their various roles in physiological and pathological processes. The available data show that COX-2 inhibitors have a favourable safety profile and are at least as effective as traditional NSAIDs for the treatment of pain and inflammatory conditions with a reduced incidence of gastrointestinal complications. Emerging evidence points to new and unanticipated effects from these agents. COX-2 inhibition appears to play an important role in the modulation of intestinal polyposis and colorectal carcinogenesis. Additionally, COX-2 expression may be associated with inflammatory responses leading to the occurrence of Alzheimer's disease and potentially, COX-2 inhibitors could be used to retard the progression of this condition. However, by decreasing prostacyclin production, COX-2 inhibitors may lead to increased prothrombotic activity and increase the risk of cardiovascular events. Until further large-scale prospective studies are performed, and the magnitude of these potential risks is quantified, COX-2 inhibitors should be used with caution in patients at risk for cardiovascular morbidity.
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