Cardiovascular hazard of selective COX-2 inhibitors: myth or reality?

Details

Serval ID
serval:BIB_25296
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Cardiovascular hazard of selective COX-2 inhibitors: myth or reality?
Journal
Expert opinion on drug safety
Author(s)
Chiolero A., Maillard M.P., Burnier M.
ISSN
1474-0338 (Print)
ISSN-L
1474-0338
Publication state
Published
Issued date
05/2002
Peer-reviewed
Oui
Volume
1
Number
1
Pages
45-52
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
Since 1998, two selective inhibitors of COX-2 have been approved in many countries for the treatment of rheumatoid arthritis, osteoarthritis and acute pain. These new drugs have a significantly reduced gastrointestinal toxicity when compared with non-selective COX inhibitors. However, the results of two large clinical trials conducted in patients with osteoarthritis and rheumatoid arthritis have recently raised some concerns regarding the cardiovascular safety of these new drugs. The purpose of this paper is to review the potential mechanisms whereby selective COX-2 inhibitors could increase the cardiovascular risk of patients and to analyse the data indicating that this clinical risk indeed exists. The authors' analysis shows that even though there are pathophysiological mechanisms which could explain why selective COX-2 inhibition might increase the cardiovascular risk in patients, the actual level of evidence demonstrating that the risk is indeed increased is weak. Because of the importance of the issue, additional studies must be conducted with this class of agents. Meanwhile, it is crucial to emphasise that neither selective COX-2 inhibitors nor conventional NSAIDs replace aspirin in patients with a high cardiovascular risk.
Keywords
Anti-Inflammatory Agents, Non-Steroidal/adverse effects, Anti-Inflammatory Agents, Non-Steroidal/therapeutic use, Arthritis, Rheumatoid/drug therapy, Aspirin/adverse effects, Aspirin/therapeutic use, Cardiovascular Diseases/chemically induced, Cardiovascular Diseases/epidemiology, Cardiovascular Diseases/mortality, Celecoxib, Clinical Trials as Topic, Cyclooxygenase Inhibitors/adverse effects, Cyclooxygenase Inhibitors/therapeutic use, Humans, Lactones/adverse effects, Lactones/therapeutic use, Osteoarthritis/drug therapy, Pyrazoles, Risk Factors, Sulfonamides/adverse effects, Sulfonamides/therapeutic use, Sulfones
Pubmed
Create date
19/11/2007 12:21
Last modification date
11/09/2019 5:26
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