Cyclooxygenase-2 specific inhibitors: a revolution?

A new class of NSAID: All non-steroidal antiinflammatory drugs (NSAID) inhi bit cyclooxygenase (COX) and prostaglandin synthesis implicated in inflamma tory processes and abo participate in protecting the gastric mucosa. The di scovery of two isoforms of COX, called COX-1 and COX-2 has led to further r esearch into dissociating NSAID efficacy and intolerance. COX-1 and COX-2: It appears that the antiinflammatory and antalgesic-effect s of NSAID is related to COX-2;inhibition while the undesirable effects on the gastric mucosa would be related to COX-1 inhibition. A COX-2 specific i nhibitor would thus provide the same efficacy as classic NSAID but without the digestive disadvantages. Clinical results: Celecoxib and rofecoxib are two COX-2 specific inhibitors . They have been found to have an effect comparable to classical NSAID. Further information needed: The fact that healthy gastric mucosa tolerates COX-2 specific inhibitors better does not necessarily mean that the same wo uld be true for ulcerated mucose, poorly repaired mucosa or simple areas of erosion.