Why Were Selective COX-2 Inhibitors Developed?
Prior to 2003, patients with osteoarthritis and rheumatoid arthritis were almost exclusively given nonselective NSAIDs. These enzyme inhibitors provided analgesic and anti-inflammatory benefits, but also inhibited the gastroprotective effects of COX-1. In recent years, however, their widespread and often excessive use has resulted in an annual 103,000 hospitalizations and 16,500 deaths in the United States. The major adverse drug reaction associated with nonselective NSAIDs is gastrointestinal irritation. In response to the gastrointestinal toxicity of nonselective NSAIDs, two agents were developed: proton pump inhibitors and selective COX-2 inhibitors. Proton pump inhibitors are a class of drugs that reduce the bodys production of gastric acid, thereby reducing ulceration and other GI problems. Selective COX-2 inhibitors interact with only COX-2 enzymes and therefore do not interfere with gastric mucosa protection. Numerous clinical tests confirmed hopes that selective COX-2 inhibitor
