Abstract
Non-steroidal antiinflammatory drugs (NSAIDs) are standard treatment for the pain and inflammation associated with arthritis. Traditional NSAIDs and cyclooxygenase-2 (COX-2) selective inhibitors exhibit comparable efficacy, with different safety profiles. Traditional NSAIDs are associated with an increased risk of serious gastrointestinal (GI) adverse events versus COX-2 selective inhibitors, and chronic use frequently necessitates adjunctive therapy with gastroprotective agents. COX-2 selective inhibitors are often used in preference to avoid these GI adverse events. Recent studies have raised the concern that COX-2 selective inhibitors and traditional NSAIDs appear to be associated with a higher incidence of thrombotic cardiovascular events versus placebo. The key in prescribing these agents is for the physician to take a proactive approach to patient management and evaluation of GI and cardiovascular risk factors. This review examines the role of the newest COX-2 selective inhibitors, etoricoxib and lumiracoxib, in treating rheumatic disease.
Publication types
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Research Support, Non-U.S. Gov't
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Review
MeSH terms
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Anti-Inflammatory Agents, Non-Steroidal / adverse effects
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Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
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Arthritis, Gouty / drug therapy
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Arthritis, Gouty / enzymology
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Arthritis, Rheumatoid / drug therapy
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Arthritis, Rheumatoid / enzymology
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Cardiovascular Diseases / chemically induced
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Cyclooxygenase 2 / metabolism*
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Cyclooxygenase 2 Inhibitors / adverse effects
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Cyclooxygenase 2 Inhibitors / therapeutic use*
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Diclofenac / adverse effects
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Diclofenac / analogs & derivatives*
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Diclofenac / therapeutic use
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Etoricoxib
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Gastrointestinal Hemorrhage / chemically induced
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Humans
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Membrane Proteins / metabolism*
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Osteoarthritis / drug therapy
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Osteoarthritis / enzymology
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Patient Selection
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Pyridines / adverse effects
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Pyridines / therapeutic use*
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Rheumatic Diseases / drug therapy*
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Rheumatic Diseases / enzymology
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Risk Assessment
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Risk Factors
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Spondylitis, Ankylosing / drug therapy
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Spondylitis, Ankylosing / enzymology
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Sulfones / adverse effects
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Sulfones / therapeutic use*
Substances
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Anti-Inflammatory Agents, Non-Steroidal
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Cyclooxygenase 2 Inhibitors
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Membrane Proteins
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Pyridines
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Sulfones
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Diclofenac
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Cyclooxygenase 2
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PTGS2 protein, human
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lumiracoxib
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Etoricoxib