Engelsk titel: COX-2 inhibitors - one step forward and two steps back
Läs online
Författare:
Evensen S
;
Spigset O
;
Slördal L
Email: lars.slordal@medisin.ntnu.no
Språk: Nor
Antal referenser: 39
Dokumenttyp:
Översikt
UI-nummer: 05041543
Sammanfattning
BACKGROUND : Selective cyclooxygenase-2 (COX-2) inhibitors are widely used. They have no advantages in terms of efficacy, and it is not documented that they cause fewer adverse effects than conventional NSAIDs.
MATERIAL AND METHODS : The adverse effects of rofecoxib, celecoxib and other NSAIDs are reviewed. Relevant literature was identified on Medline and in the reference lists in key articles.
RESULTS : Rofecoxib and the novel COX-2 inhibitors etoricoxib and valdecoxib have a higher degree of COX-2 selectivity than traditional NSAIDs. Celecoxib is less COX-2 selective and appears to be similar to diclofenac. Rofecoxib induces thromboembolic adverse effects more frequently than conventional NSAIDs.
INTERPRETATION : The cardiovascular problems conferred by rofecoxib are probably a class effect and thus inducible by other selective COX-2 inhibitors. Pending comprehensive safety data, caution is warranted regarding the use of these drugs.