Are COX-2 inhibitors safer?
NEW ORLEANS, LA—Ten years in the making, with more than two out of three patients dropping out of the study, the PRECISION trial has found that the COX-2 inhibitor celecoxib is as safe—from a cardiovascular standpoint—as two of the world’s most popular anti-inflammatory drugs, ibuprofen and naproxen.
Why are COX-2 inhibitors bad?
After several COX-2-inhibiting drugs were approved for marketing, data from clinical trials revealed that COX-2 inhibitors caused a significant increase in heart attacks and strokes, with some drugs in the class having worse risks than others.
Who should avoid COX-2 inhibitors?
 COX inhibitors, non-specific NSAIDs, and COX-2 specific NSAIDs can both have adverse effects on the kidney. They are important players in vasoconstriction at the afferent arteriole level of the kidney. COX inhibitors should be avoided in patients with hypovolemia, prior kidney disease, or hypotension.
Why were some COX-2 inhibitors removed from the market?
Objective: Cyclo-oxygenase-2 (COX-2) inhibitors rofecoxib and valdecoxib were withdrawn from the market because of their association with cardiovascular problems. There is a lack of information on the impact of the COX-2 inhibitors withdrawal on the prescribing and utilization of related drugs.
Why do COX-2 inhibitors cause heart attacks?
Selective COX-2 inhibitors increase the risk of myocardial infarction and stroke. This has been attributed to their ability to inhibit endothelial COX-2 derived prostacyclin (PGI2) but not platelet COX-1 derived thromboxane A2 (TXA2).
Are COX-2 inhibitors still on the market?
Celecoxib is the only COX-2 inhibitor currently available in the United States. Rofecoxib (Vioxx) and valdecoxib (Bextra) are no longer available because they increased the risk of heart attacks and strokes with long term use. Rofecoxib was discontinued in 2004 and valdecoxib was discontinued in 2005.
What is advantage of COX-2 inhibitors over other NSAIDs?
Selective inhibitors of COX-2-selective NSAIDs are effective antiinflammatory and analgesic drugs with improved upper-GI safety compared to traditional NSAIDs. Data on the cost-effectiveness of COX-2-selective NSAIDs indicate that they should be limited to patients at high risk for upper-GI adverse effects.
Is Aleve a COX inhibitor?
Over-the-counter NSAID medications include aspirin, ibuprofen (Advil, Motrin, and other brand names), and naproxen (Aleve), but selective COX-2 inhibitor NSAIDs are prescription medications that are more specialized in the way they work on inflammation.
Is Aleve a COX-2 inhibitor?
Which NSAID has highest cardiovascular risk?
Several meta-analyses and systematic reviews indicate that diclofenac has demonstrated the highest cardiovascular risk of any of the nonselective NSAIDs.
Are Cox-2 inhibitors still on the market?
Are COX-2 inhibitors better?
The potential clinical benefit of COX-2 inhibitors is significant due to the number of patients chronically treated with NSAIDs and the three- to ten-fold higher risk of gastrointestinal injury and death associated with traditional NSAIDs.