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Selective COX-2 inhibitors and the surgical patient
1New York Presbyterian Hospital, New York, NY, USA.
Abstract:
The identification of COX-2 less than a decade ago has been followed by an unprecedented period of discovery and drug development (Golden & Abramson, 1999). Clinical studies thus far have established that the selective COX-2 inhibitors, celecoxib (Celebrex) and rofecoxib (Vioxx) are effective in the treatment of OA and RA, as are conventional NSAIDs. However, they do not cause the same adverse effects on the GI mucosa nor do they increase bleeding time as do conventional NSAIDs. Therefore, their use is not contraindicated in pre or postsurgical patients. Further investigation is underway to fully elucidate the role of COX-2 and to determine any additional benefits of selective COX-2 inhibition.
Insights
Selective COX-2 inhibitors, like celecoxib and rofecoxib, effectively treat OA and RA with fewer gastrointestinal and bleeding risks than traditional NSAIDs. Their safety profile makes them suitable for pre and postsurgical patients.
Area of Science:
- Biomedical Science
- Pharmacology
- Inflammation Research
Background:
- Cyclooxygenase-2 (COX-2) identification has spurred significant research and drug development.
- Conventional NSAIDs are effective for osteoarthritis (OA) and rheumatoid arthritis (RA) but carry risks.
Purpose of the Study:
- To review the efficacy and safety of selective COX-2 inhibitors.
- To compare adverse effects of selective COX-2 inhibitors versus conventional NSAIDs.
- To explore the potential benefits of selective COX-2 inhibition in surgical contexts.
Main Methods:
- Clinical studies evaluating celecoxib and rofecoxib.
- Comparative analysis of gastrointestinal and bleeding profiles.
- Assessment of contraindications for surgical patients.
Main Results:
- Selective COX-2 inhibitors demonstrate efficacy in treating OA and RA.
- These agents exhibit a reduced incidence of GI mucosal damage and bleeding time compared to conventional NSAIDs.
- Their safety profile suggests no contraindications for pre or postsurgical use.
Conclusions:
- Selective COX-2 inhibitors offer a safer alternative to conventional NSAIDs for OA and RA.
- Further research is needed to fully understand COX-2's role and the benefits of its selective inhibition.