The Coxibs, Selective Inhibitors of Cyclooxygenase-2

doi:10.1056/NEJM200108093450607

Volume 345:433-442		August 9, 2001		Number 6

The Coxibs, Selective Inhibitors of Cyclooxygenase-2

Garret A. FitzGerald, M.D., and Carlo Patrono, M.D.

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Nonsteroidal antiinflammatory drugs (NSAIDs) are widely usedto treat arthritis, menstrual pain, and headache. Although theyare effective, their long-term use is limited by gastrointestinaleffects such as dyspepsia and abdominal pain and, less often,gastric or duodenal perforation or bleeding. Development ofthe coxibs, a new group of antiinflammatory drugs, representsa response to the unsatisfactory therapeutic profile of NSAIDs.Both groups of drugs inhibit prostaglandin G/H synthase, theenzyme that catalyzes the transformation of arachidonic acidto a range of lipid mediators, termed prostaglandins and thromboxanes(Figure 1). However, whereas NSAIDs inhibit the two recognizedforms . . . [Full Text of this Article]

Selective and Nonselective Inhibition of Cyclooxygenase Isoforms

Pharmacokinetics and Drug Interactions

Clinical Verification of the Cyclooxygenase-2 Hypothesis

Cyclooxygenase-2, Coxibs, and Cardiovascular Disease

Cyclooxygenase-2 and Renal Function

Effects of Other Cyclooxygenase-2 Inhibitors

Conclusions

Source Information

From the Center for Experimental Therapeutics, University of Pennsylvania, Philadelphia (G.A.F.); and the Department of Medicine and Center of Excellence on Aging, University of Chieti, Chieti, Italy (C.P.).

Address reprint requests to Dr. FitzGerald at the Department of Pharmacology, 153 Johnson Pavilion, 3620 Hamilton Walk, University of Pennsylvania, Philadelphia, PA 19104-6084, or at garret@spirit.gcrc.upenn.edu.

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