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Etoricoxib: a highly selective COX-2 inhibitor.
Shaunta' D Martina1, Kimi S Vesta, Toni L Ripley
1College of Pharmacy, University of Oklahoma, Oklahoma City, OK 73190-5040, USA.
The Annals of Pharmacotherapy
|April 14, 2005
Summary
Etoricoxib, a selective cyclooxygenase-2 (COX-2) inhibitor, shows efficacy for various pain conditions. However, its cardiovascular risks require further investigation compared to other treatments.
Area of Science:
- Pharmacology and Therapeutics
- Pain Management
- Drug Safety Evaluation
Background:
- Etoricoxib is a highly selective cyclooxygenase-2 (COX-2) inhibitor.
- It is not currently approved for use in the United States.
- Understanding its efficacy and safety profile is crucial.
Purpose of the Study:
- To review available literature on etoricoxib's pharmacology, pharmacokinetics, clinical efficacy, and adverse effects.
- To synthesize current evidence on its use in pain management.
Main Methods:
- Comprehensive literature search of MEDLINE, Current Contents, and Cochrane Library (up to December 2004).
- Inclusion of all published English clinical trials evaluating etoricoxib.
- Exclusion of preliminary data, previously reported analyses, and placebo-controlled trials with active comparator data.
Main Results:
- Twelve clinical trials demonstrated etoricoxib's efficacy for acute pain (gout, dysmenorrhea, dental surgery) and chronic pain (rheumatoid arthritis, osteoarthritis, lower back pain).
- Safety review included 3 clinical trials and 6 retrospective analyses focusing on gastrointestinal, renovascular, and cardiovascular adverse effects.
Conclusions:
- Etoricoxib shows efficacy comparable to nonsteroidal anti-inflammatory drugs (NSAIDs).
- No direct comparisons exist between etoricoxib and other selective COX-2 inhibitors.
- While gastrointestinal adverse effects are reduced, cardiovascular risks associated with selective COX-2 inhibition remain unclear, necessitating further research.