[Specific inhibitors of cyclo-oxygenase-2: a revolution?]

A NEW CLASS OF NSAID: All non-steroidal antiinflammatory drugs (NSAID) inhibit cyclooxygenase (COX) and prostaglandin synthesis implicated in inflammatory processes and also participate in protecting the gastric mucosa. The discovery of two isoforms of COX, called COX-1 and COX-2 has led to further research into dissociating NSAID efficacy and intolerance. COX-1 AND COX-2: It appears that the antiinflammatory and antalgesic effects of NSAID is related to COX-2 inhibition while the undesirable effects on the gastric mucosa would be related to COX-1 inhibition. A COX-2 specific inhibitor would thus provide the same efficacy as classic NSAID but without the digestive disadvantages.

Celecoxib and rofecoxib are two COX-2 specific inhibitors. They have been found to have an effect comparable to classical NSAID.

The fact that healthy gastric mucosa tolerates COX-2 specific inhibitors better does not necessarily mean that the same would be true for ulcerated mucosa, poorly repaired mucosa or simple areas of erosion.