Are the biologic and clinical effects of the COX-2-specific inhibitors an advance compared with the effects of traditional NSAIDs?

Current Opinion in Rheumatology

Volumn 12, Issue 3, 2000, Pages 163-170

  Simon, Lee S ^a,b  

^a HARVARD MEDICAL SCHOOL   (United States)

^b BETH ISRAEL DEACONESS MEDICAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CYCLOOXYGENASE 1; CYCLOOXYGENASE 1 INHIBITOR; CYCLOOXYGENASE 2; CYCLOOXYGENASE 2 INHIBITOR; NONSTEROID ANTIINFLAMMATORY AGENT;

ARTHRITIS; CHRONIC PAIN; DRUG EFFECT; ENZYME INHIBITION; ENZYME REGULATION; HUMAN; INFLAMMATION; PRIORITY JOURNAL; PROTEIN EXPRESSION; REVIEW;

ANTI-INFLAMMATORY AGENTS, NON-STEROIDAL; ARTHRITIS; CHRONIC DISEASE; CLINICAL TRIALS; CYCLOOXYGENASE 2; CYCLOOXYGENASE 2 INHIBITORS; CYCLOOXYGENASE INHIBITORS; HUMANS; ISOENZYMES; MEMBRANE PROTEINS; PAIN; PROSTAGLANDIN-ENDOPEROXIDE SYNTHASES; TREATMENT OUTCOME;

EID: 0034052747     PISSN: 10408711     EISSN: None     Source Type: Journal    
DOI: 10.1097/00002281-200005000-00001     Document Type: Review

References (67)

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45. 45 Ehrich EW, Schnitzer TJ, McIlwain H, Levy R, Wolfe F, Weisman M, et al.: Effect of specific COX-2 inhibition in osteoarthritis of the knee: a 6-week double-blind, placebo controlled, pilot study of rofecoxib. J Rheumatol 1999, 26:2438-2447. These data demonstrate that this drug is effective in the treatment of patients with OA.
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47. 47 Bensen WG, Fiechtner JJ, McMillen JI, Zhao WW, Yu SS, Woods EM, Hubbard RC, Isakson PC, Verburg KM, Geis GS: Treatment of osteoarthritis with celecoxib, a cyclooxygenase-2 inhibitor: a randomized clinical trial. Mayo Clin Proc 1999, 74:1095-1105. This paper demonstrates efficacy of celecoxib in the treatment of patients with OA.
48. 48 Zhao SZ, McMillen JI, Markenson JA, Dedhiya SD, Zhao WW, Osterhaus JT, Yu SS: Evaluation of the functional status aspects of health related quality of life of patients with osteoarthritis treated with celecoxib. Pharmacotherapy 1999, 19:1269-1278. This paper demonstrates that celecoxib improves the quality of life of patients with OA.
49. 49 Simon LS, Weaver AL, Graham DY, Kivitz AJ, Lipsky PE, Hubbard RC, Isakson PC, Verbrg KM, Yu SS, Zhao WW, Geis GS: The anti-inflammatory and upper gastrointestinal effects of celecoxib in rheumatoid arthritis: a randomized, controlled trial. JAMA 1999, 282:1921-1928. This paper demonstrates that celecoxib is effective in treating RA and at twice daily doses of 100 mg, 200 mg, and 400 mg, and that it is as effective as naproxen at 500 mg twice daily, but causes about 77% fewer upper GI ulcers as determined by endoscopy. The incidence of ulcers was no different with placebo than at any dose of celecoxib.
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62. 62 Ogino K, Hatanaka K, Kawamura M, Katori M, Harada Y: Evaluation of pharmacological profile of meloxicam as an anti-inflammatory agent, with particular reference to its relative selectivity for cyclooxygenase-2 over cyclooxygenase-1. Pharmacology 1997, 55:44-53.
63. 63 Dequeker J, Hawkey C, Kahan A, Steinbruck K, Alegre C, Baumelou E, Begaud B, Isonaki H, Littlejohn G, Mau J, Papazoglou S: Improvement in gastrointestinal tolerability of the selective cyclooxygenase (COX)-2 inhibitor, meloxicam, compared with piroxicam: results of the Safety and Efficacy Large Scale Evaluation of COX-inhibiting Therapies (SELECT) trial in osteoarthritis. Br J Rheumatol 1998, 37:946-951.
64. 64 Hawkey C, Kahan A, Steinbruck K, Alegre C, Baumelou E, Begaud B, Dequeker J, Isomaki H, Littlejohn G, Mau J, Papazoglou S: Gastrointestinal tolerability of meloxicam compared to diclofenac in osteoarthritis patients. International MELISSA Study Group. Meloxicam Large-scale International Study Safety Assessment. Br J Rheumatol 1998, 37:937-945.
65. 65 Tegeder I, Lotsch J, Krebs S, Muth-Selbach U, Brune K, Geisslinger G: Comparison of inhibitory effects of meloxicam and diclofenac on human thromboxane biosynthesis after single doses and at steady state. Clin Pharmacol Ther 1999, 65:533-544. This paper demonstrates that meloxicam does have an effect on platelets, suggesting that at higher doses it is not importantly selective for COX-2.
66. 66 Panara MR, Renda G, Sciulli MG, Santini G, Di Giamberardino M, Rotondo MT, Tacconelli, S, Seta F, Patrono C, Patrignani P: Dose-dependent inhibition of platelet cyclooxygenase-1 and monocyte cyclooxygenase-2 by meloxicam in healthy subjects. J Pharmacol Exp Ther 1999, 290:276-280. Again demonstrates that meloxicam is selective for COX-2 at low doses.
67. 67 De Meijer A, Vollaard H, de Metz M, Berbruggen B, Thomas C, Novakova I: Meloxicam, 15 mg/day spares platelet function in healthy volunteers. Clin Pharamacol Ther 1999, 66:425-430. This paper attempts to demonstrate that meloxicam at a high dose in normal volunteers does not have an effect on platelet function. This paper and the previous two are evidence that the reader must be very careful in the interpretation of experiments that use systems that are time-and temperature-dependent to prove hypotheses. These three papers reach different conclusions about the effects of meloxicam on platelet function, probably because they used different model systems to prove the initial hypotheses.