Interpreting the clinical significance of the differential inhibition of cyclooxygenase-1 and cyclooxygenase-2

The International Consensus Meeting on the Mode of Action of COX-2 Inhibiti on (ICMMAC) brought together 17 international experts in arthritis, gastroe nterology and pharmacology on 5-6 December 1997. The meeting was convened t o provide a definition of COX-2 specificity and to consider the clinical re levance of COX-2-specific agents. These compounds are a new class of drugs that specifically inhibit the enzyme COX-2 while having no effect on COX-1 across the whole therapeutic dose range. The objectives of the meeting were to review the currently available data regarding the roles and biology of COX-1 and COX-2, and to foster a consensus definition on COX-2 specificity. At the present time, no guidelines exist for the in vitro and in vivo asse ssment of COX specificity, and it was felt that consensus discussion might clarify some of these issues. The meeting also reviewed recent clinical dat a on COX-2-specific inhibitors. The following article reflects discussion a t this meeting and provides a consensus definition of COX-2-specific inhibi tors.