Assessment of the safety of selective cyclo-oxygenase-2 inhibitors: where are we in 2003?

摘要: Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most widely used worldwide despite their well-documented adverse gastrointestinal (GI) effects. The risk of developing a severe GI event varies from patient to and NSAID NSAID. Selective cyclo-oxygenase-2 inhibitors (coxibs) have been designed similar efficacy but less toxicity than traditional NSAIDs, shown an improved tolerability events across range different safety assessments. In clinical trials, particularly VIGOR CLASS, rofecoxib celecoxib, respectively, significantly reduce ulcers ulcer complications nonselective comparators with rates comparable placebo. real benefit coxib comes sparing thromboxane hence preservation normal platelet function. Thus, there is bleeding selective inhibition COX-2, which common serious complication non-selective NSAIDs. Moreover, can occur anywhere in tract. Although some concern has raised about cardiovascular coxibs, when recommended doses, no convincing evidence that patients treated increased thrombotic events. Different approaches advocated minimize NSAID-related toxicity. Choice harmful NSAIDs such as one strategies promoted guidelines. introduction coxibs higher benefit-risk ratio dramatically changed therapeutic scenario for treatment practice.