Management of Inflammatory Pain with Selective COX-2 Inhibitors: Promises and Facts

The discovery that two cyclooxygenase (COX) isoenzymes, including inducible forms (COX-2), could be selectively inhibited has triggered new research to develop selective inhibitors. During this process, pharmacotherapeutic concepts in inflammatory pain, and clinicians over-expectations, have created some degree of uncertainty for clinicians about the promise of COX-2 inhibitors and the real role they play. The purpose of this article is to critically review, within the context of NSAIDs, some of the old and new concepts in the management of inflammatory pain, as well as to examine the current evidence of the usefulness of COX-2 inhibitors today.