Cardio-renal safety of non-steroidal anti-inflammatory drugs

J Toxicol Sci. 2019;44(6):373-391. doi: 10.2131/jts.44.373.

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most widely used therapeutic class in clinical medicine. These are sub-divided based on their selectivity for inhibition of cyclooxygenase (COX) isoforms (COX-1 and COX-2) into: (1) non-selective (ns-NSAIDs), and (2) selective NSAIDs (s-NSAIDs) with preferential inhibition of COX-2 isozyme. The safety and pathophysiology of NSAIDs on the renal and cardiovascular systems have continued to evolve over the years following short- and long-term treatment in both preclinical models and humans. This review summarizes major learnings on cardiac and renal complications associated with pharmaceutical inhibition of COX-1 and COX-2 with focus on preclinical to clinical translatability of cardio-renal data.

Keywords: COX-1; COX-2; Heart; Kidney; Prostaglandins; ns-NSAIDs; s-NSAIDs.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents, Non-Steroidal / pharmacology*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Cyclooxygenase 1 / metabolism
  • Cyclooxygenase 2 / metabolism
  • Heart / drug effects*
  • Humans
  • Kidney / drug effects*
  • Kidney / metabolism
  • Myocardium / metabolism

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Cyclooxygenase 1
  • Cyclooxygenase 2