Abstract
The withdrawal of the celebrity arthritis drug, rofecoxib (Vioxx) has sparked an intense discussion and controversy about the safety of the selective COX-2 inhibitors. Laboratory, epidemiological, and clinical studies have surged and continued to evaluate and understand the safety of coxibs and traditional NSAIDs. This paper reviews the scientific and clinical basis of not only the risks, but also the benefits surrounding the use COX-2 inhibitors and NSAIDs. Discussion, debate, opinions, regulatory and clinical recommendations have evolved since the unexpected emergence of cardiac thrombotic events from the use of these drugs. The evidence by which coxibs and NSAIDs can potentially attenuate or exacerbate cardiovascular disease by affecting endothelial function is assessed; and how NSAIDs and coxibs affect renal function and blood pressure is revisited. Several investigations provide insight into their mechanism and clinical application.
Keywords: COX-2 inhibition, COX-blockade, NSAIDs, coxibs, COX-2 selective inhibitor, COX-2 specific inhibitor, endothelial dysfunction, gastrointestinal toxicity
Current Drug Safety
Title: Risk-Benefit Perspectives in COX-2 Blockade
Volume: 3 Issue: 1
Author(s): Susan Dabu-Bondoc and Samantha Franco
Affiliation:
Keywords: COX-2 inhibition, COX-blockade, NSAIDs, coxibs, COX-2 selective inhibitor, COX-2 specific inhibitor, endothelial dysfunction, gastrointestinal toxicity
Abstract: The withdrawal of the celebrity arthritis drug, rofecoxib (Vioxx) has sparked an intense discussion and controversy about the safety of the selective COX-2 inhibitors. Laboratory, epidemiological, and clinical studies have surged and continued to evaluate and understand the safety of coxibs and traditional NSAIDs. This paper reviews the scientific and clinical basis of not only the risks, but also the benefits surrounding the use COX-2 inhibitors and NSAIDs. Discussion, debate, opinions, regulatory and clinical recommendations have evolved since the unexpected emergence of cardiac thrombotic events from the use of these drugs. The evidence by which coxibs and NSAIDs can potentially attenuate or exacerbate cardiovascular disease by affecting endothelial function is assessed; and how NSAIDs and coxibs affect renal function and blood pressure is revisited. Several investigations provide insight into their mechanism and clinical application.
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Cite this article as:
Dabu-Bondoc Susan and Franco Samantha, Risk-Benefit Perspectives in COX-2 Blockade, Current Drug Safety 2008; 3 (1) . https://dx.doi.org/10.2174/157488608783333970
DOI https://dx.doi.org/10.2174/157488608783333970 |
Print ISSN 1574-8863 |
Publisher Name Bentham Science Publisher |
Online ISSN 2212-3911 |
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