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[Rheumatology. Do coxibs pose a cardiovascular risk?]
1Service de rhumatologie, médecine physique et rehabilitation, Av. Pierre Decker 5, CHUV, 1011 Lausanne. aso@chuv.hospvd.ch
Revue Medicale Suisse
|March 19, 2005
Summary
The cardiovascular safety of COX-2 inhibitors (coxibes) remains debated. While COX-2 inhibition may increase clotting risk, current data doesn't confirm a class-wide effect in humans, warranting careful prescription.
Area of Science:
- Pharmacology
- Cardiovascular Medicine
- Gastroenterology
Context:
- Ongoing debate surrounds the cardiovascular safety of selective COX-2 inhibitors (coxibs).
- COX-2 inhibition's potential pro-coagulant effects are a key area of concern.
- Clinical data regarding a class effect in human use remains inconclusive.
Purpose:
- To review the cardiovascular safety profile of coxibs.
- To provide guidance on the appropriate clinical use of coxibs.
- To differentiate between gastrointestinal and cardiovascular risk factors in treatment decisions.
Summary:
- While COX-2 inhibition might theoretically promote coagulation, available human data does not establish a universal class effect for coxibs.
- Clinical use necessitates careful patient assessment, particularly for treatments exceeding one week.
- Individual cardiovascular and gastrointestinal risk profiles should guide the choice between coxibs and traditional NSAIDs with gastric protection.
Impact:
- Informs clinical decision-making regarding coxib prescription.
- Highlights the importance of personalized risk assessment in NSAID selection.
- Contributes to the understanding of coxib-related cardiovascular risks and benefits.