Abstract
COX-2 selective inhibitors were developed in order to provide similar efficacy to traditional nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) but with improved upper gastrointestinal safety. This paper presents an overview of randomized clinical trials demonstrating the efficacy of COX-2 selective inhibitors for the treatment of patients with arthritis, particularly osteoarthritis and rheumatoid arthritis. In osteoarthritis and rheumatoid arthritis, COX-2 selective inhibitors have been shown to be more effective than placebo and similarly effective as standard doses of nonselective NSAIDs. There are currently few randomized clinical trials comparing the efficacy of the 2 first-generation COX-2 selective inhibitors, celecoxib and rofecoxib, in osteoarthritis. Of 4 head-to-head studies comparing the 2 agents, 3 indicated similar efficacy, while the other demonstrated superiority of rofecoxib at a dose of 25 mg qd compared with celecoxib at a dose of 200 mg qd. There are no clinical trials comparing the efficacy of different agents for treatment of patients with rheumatoid arthritis. Some studies have also demonstrated efficacy for COX-2 selective inhibitors in patients with ankylosing spondylitis and gout. In aggregate, these data show that COX-2 selective inhibitors provide effective relief of pain in patients with osteoarthritis and rheumatoid arthritis, with efficacy that is similar to traditional NSAIDs. Costeffectiveness and cost-utility studies suggest, however, that their use should be limited to patients at high risk of serious upper gastrointestinal side effects, including complicated ulcers.
Keywords: osteoarthritis, nsaids, valdecoxib, celecoxib, rofecoxib, naproxen, randomized clinical trials, gout, lumiracoxib
Current Topics in Medicinal Chemistry
Title: COX-2 Selective Inhibitors in the Treatment of Arthritis: A Rheumatologist Perspective
Volume: 5 Issue: 5
Author(s): M. C. Hochberg
Affiliation:
Keywords: osteoarthritis, nsaids, valdecoxib, celecoxib, rofecoxib, naproxen, randomized clinical trials, gout, lumiracoxib
Abstract: COX-2 selective inhibitors were developed in order to provide similar efficacy to traditional nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) but with improved upper gastrointestinal safety. This paper presents an overview of randomized clinical trials demonstrating the efficacy of COX-2 selective inhibitors for the treatment of patients with arthritis, particularly osteoarthritis and rheumatoid arthritis. In osteoarthritis and rheumatoid arthritis, COX-2 selective inhibitors have been shown to be more effective than placebo and similarly effective as standard doses of nonselective NSAIDs. There are currently few randomized clinical trials comparing the efficacy of the 2 first-generation COX-2 selective inhibitors, celecoxib and rofecoxib, in osteoarthritis. Of 4 head-to-head studies comparing the 2 agents, 3 indicated similar efficacy, while the other demonstrated superiority of rofecoxib at a dose of 25 mg qd compared with celecoxib at a dose of 200 mg qd. There are no clinical trials comparing the efficacy of different agents for treatment of patients with rheumatoid arthritis. Some studies have also demonstrated efficacy for COX-2 selective inhibitors in patients with ankylosing spondylitis and gout. In aggregate, these data show that COX-2 selective inhibitors provide effective relief of pain in patients with osteoarthritis and rheumatoid arthritis, with efficacy that is similar to traditional NSAIDs. Costeffectiveness and cost-utility studies suggest, however, that their use should be limited to patients at high risk of serious upper gastrointestinal side effects, including complicated ulcers.
Export Options
About this article
Cite this article as:
Hochberg C. M., COX-2 Selective Inhibitors in the Treatment of Arthritis: A Rheumatologist Perspective, Current Topics in Medicinal Chemistry 2005; 5 (5) . https://dx.doi.org/10.2174/1568026054201695
DOI https://dx.doi.org/10.2174/1568026054201695 |
Print ISSN 1568-0266 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4294 |
Call for Papers in Thematic Issues
Chemistry Based on Natural Products for Therapeutic Purposes
The development of new pharmaceuticals for a wide range of medical conditions has long relied on the identification of promising natural products (NPs). There are over sixty percent of cancer, infectious illness, and CNS disease medications that include an NP pharmacophore, according to the Food and Drug Administration. Since NP ...read more
Current Trends in Drug Discovery Based on Artificial Intelligence and Computer-Aided Drug Design
Drug development discovery has faced several challenges over the years. In fact, the evolution of classical approaches to modern methods using computational methods, or Computer-Aided Drug Design (CADD), has shown promising and essential results in any drug discovery campaign. Among these methods, molecular docking is one of the most notable ...read more
Drug Discovery in the Age of Artificial Intelligence
In the age of artificial intelligence (AI), we have witnessed a significant boom in AI techniques for drug discovery. AI techniques are increasingly integrated and accelerating the drug discovery process. These developments have not only attracted the attention of academia and industry but also raised important questions regarding the selection ...read more
From Biodiversity to Chemical Diversity: Focus of Flavonoids
Flavonoids are the largest group of polyphenols, plant secondary metabolites arising from the essential aromatic amino acid phenylalanine (or more rarely from tyrosine) via the phenylpropanoid pathway. The flavan nucleus is the basic 15-carbon skeleton of flavonoids (C6-C3-C6), which consists of two phenyl rings (A and B) and a heterocyclic ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Update on ICOS: A Possible Target for Turning-Off Autoimmunity
Recent Patents on Endocrine, Metabolic & Immune Drug Discovery Advancements in Adjuvanticity of Bioactive Inorganic and Organic Compounds
Endocrine, Metabolic & Immune Disorders - Drug Targets Indolinones as Promising Scaffold as Kinase Inhibitors: A Review
Mini-Reviews in Medicinal Chemistry Impacts of Nanoparticles on Cardiovascular Diseases: Modulating Metabolism and Function of Endothelial Cells
Current Drug Metabolism Hemolysis and Rhabdomyolysis after Marathon and Long Distance Running
Immunology, Endocrine & Metabolic Agents in Medicinal Chemistry (Discontinued) From Leflunomide to Teriflunomide: Drug Development and Immunosuppressive Oral Drugs in the Treatment of Multiple Sclerosis
Current Neuropharmacology Role of Beta2 Agonists in Respiratory Medicine with Particular Attention to Novel Patents and Effects on Endocrine System and Immune Response
Recent Patents on Endocrine, Metabolic & Immune Drug Discovery NF-κB in Anti-Inflammatory Activity of Probiotics: An Update
Current Immunology Reviews (Discontinued) Editorial [Hot Topic: Benefits, Problems and Alternatives to COX-2 Inhibition (Guest Editor: Angel Lanas)]
Current Topics in Medicinal Chemistry Comparative Account of Quality Management and Regulatory Aspects of Products with Health Claims: Existing Approaches and Future Challenges for Probiotics and Herbal Products
Applied Clinical Research, Clinical Trials and Regulatory Affairs Association of Anti-cyclic Citrullinated Peptide Antibodies with Clinical and Radiological Disease Severity in Rheumatoid Arthritis
Current Rheumatology Reviews Recent Developments of Amidine-like Compounds as Selective NOS Inhibitors
Current Enzyme Inhibition The Shift in the “Paradigm” of the Pharmacology of Hypertension
Current Topics in Medicinal Chemistry Targeted Delivery of Anti-Inflammatory Agents to Tumors
Current Pharmaceutical Design microRNA in Chondrogenesis, Cartilage and Osteoarthritis
Current Rheumatology Reviews The Relevance of IgE in the Pathogenesis of Allergy: The Effect of an Anti-IgE Drug in Asthma and Other Diseases
Recent Patents on Inflammation & Allergy Drug Discovery Role of Novel Drug Delivery Systems in Coronavirus Disease-2019 (COVID-19): Time to Act Now
Current Drug Delivery An Overview of the Modulatory Effects of Oleic Acid in Health and Disease
Mini-Reviews in Medicinal Chemistry Biological Therapies of Autoimmune Diseases
Current Drug Targets - Inflammation & Allergy Inducible Nitric Oxide Synthase Inhibition by Mycophenolic Acid
Mini-Reviews in Medicinal Chemistry