How significant are cardiovascular adverse events with use of COX-2 inhibitors?
Cyclooxygenase (COX) enzyme is responsible for the formation of prostaglandins from arachidonic acid. Two COX isoenzymes have been identified, COX-1 and COX-2. COX-1 is found in many tissues and blood components such as platelets. COX-2 on the other hand is found predominantly at sites of inflammation in the body. COX-1 is responsible for promoting platelet aggregation, protecting the gastric mucosa, and maintaining renal function. Inhibition of COX-1 contributes to the gastrointestinal toxicity of traditional nonsteroidal anti-inflammatory drugs (NSAIDs). Celecoxib and rofecoxib are NSAIDs that selectively inhibit COX-2. Celecoxib is approved for osteoarthritis, rheumatoid arthritis, and for decreasing the number of polyps in familial adenomatous polyposis. Rofecoxib is indicated for osteoarthritis, acute pain relief, and primary dysmenorrhea. COX-2 inhibitors have been extremely well received by the medical community and are in the top 20 of Pharmacy Times’ top 200 drugs ranked by do
