[The choice of selective COX-2 inhibitors]

Non-steroidal anti-inflammatory drug (NSAID) has been widely prescribed as a useful antifebrile or painkiller. But, gastrointestinal injury as a side effect of NSAIDs has been a big social probrem. NSAID-induced gastric damage has been shown to be induced by the inhibition of both cyclooxygenase (COX)-1 and 2. Thus, selective COX-2 inhibitors are expected to induce less gastric injury and to be safe as compared to traditional NSAIDs. But in certain situations such as gastric ulcer or H. pylori-induced gastritis, selective COX-2 inhibitors may delay ulcer healing or repair processes. Previous reports have shown that COX-2 inhibitors increase cardiovascular (CV) events as compared with placebo and recent studies further suggest that all NSAIDs might also be involved in increases in CV events. Therefore, any NSAIDs must be carefully used when they are prescribed for patients with CV risks.