Are COX-2 selective inhibitors effective analgesics?
In this review article we undertake an assessment of the comparative performance of cyclooxygenase-2 (COX-2) selective agents in managing nonarthritic conditions. Clinical and in-vivo reports were identified through the use of the computer databases MEDLINE and EMBASE. Our findings reveal that, gene...
| Publicado en: | Pain Reviews Vol. 8; no. 1; pp. 13 - 27 |
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| Autores principales: | , |
| Formato: | review tables/charts Journal Article |
| Publicado: |
Sage Publications, Ltd.
Apr2001
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106813201&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106813201 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09681302 31H jtl: Pain Reviews issn: 09681302 maglogo: N pubinfo: dt: Apr2001 vid: 8 iid: 1 pid: 33180 pub: Sage Publications, Ltd. place: <Blank> artinfo: ui: 106813201 106813201 2003041537 106813201 ppf: 13 ppct: 14 formats: tig: atl: Are COX-2 selective inhibitors effective analgesics? aug: au: McCormack K Twycross R affil: McCormack Drug Research Gruop, Jubilee Business Centres, Exeter Road, London NW2 3UF, UK; keith@nrueopathyresearch.com sug: subj: Cox-2 Inhibitors Therapeutic Use Pain Drug Therapy Clinical Research In Vivo Studies Treatment Outcomes Cox-2 Inhibitors Administration and Dosage Cox-2 Inhibitors Pharmacodynamics Cox-2 Inhibitors Pharmacokinetics Postoperative Pain Drug Therapy Neuralgia Drug Therapy Inflammation Physiopathology Isoenzymes Antiinflammatory Agents, Non-Steroidal Models, Biological Dose-Response Relationship, Drug ab: In this review article we undertake an assessment of the comparative performance of cyclooxygenase-2 (COX-2) selective agents in managing nonarthritic conditions. Clinical and in-vivo reports were identified through the use of the computer databases MEDLINE and EMBASE. Our findings reveal that, generally, clinical evidence for the effectiveness of COX-2 selective agents in the treatment of nonarthritic conditions is either equivocal or lacking. In the management of postoperative dental pain, rofecoxib 50 mg exhibits analgesic efficacy comparable with that of ibuprofen 400 mg. For celecoxib 200 mg, analgesic efficacy appears comparable with that of aspirin 650 mg, but less than that of ibuprofen 400 mg or rofecoxib 50 mg. In addition to the probability of a type II statistical error in some of these studies, we also present novel arguments for previously unconsidered sources of confounding. In-vivo outcomes using established animal models of clinical pain are consistent with limited clinical utility. SC-58125 and SC-236 at the highest dose employed failed to alter the second phase of the formalin test, and NS-398, nimesulide, and L-745337 had no effect upon writhings induced by intraperitoneal acetic acid. Overall, we conclude that at present there are insufficient grounds for assuming analgesic equivalence between COX-2 selective and dual inhibitors across a wide range of acute tonic pains. For many pains, in order to achieve maximal analgesia, inhibition of both COX isoenzymes appears to be requisite. pubtype: Academic Journal doctype: review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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