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Titolo:
COX-1 and COX-2 inhibitors
Autore:
Hawkey, CJ;
Indirizzi:
Univ Nottingham Hosp, Queens Med Ctr, Div Gastroenterol, Nottingham NG7 2UH, England Univ Nottingham Hosp Nottingham England NG7 2UH tingham NG7 2UH, England
Titolo Testata:
BEST PRACTICE & RESEARCH IN CLINICAL GASTROENTEROLOGY
fascicolo: 5, volume: 15, anno: 2001,
pagine: 801 - 820
SICI:
1521-6918(200110)15:5<801:CACI>2.0.ZU;2-I
Fonte:
ISI
Lingua:
ENG
Soggetto:
NONSTEROIDAL ANTIINFLAMMATORY DRUGS; RANDOMIZED CONTROLLED TRIAL; MELOXICAM 15 MG; PROSTAGLANDIN ENDOPEROXIDE SYNTHASES; LONG-TERM MANAGEMENT; DOUBLE-BLIND TRIAL; FECAL BLOOD-LOSS; PIROXICAM 20 MG; RHEUMATOID-ARTHRITIS; CYCLOOXYGENASE-2 INHIBITOR;
Keywords:
non-steroidal anti-inflammatory drugs (NSAIDs); cyclo-oxygenase (COX); selective COX-2 inhibitors; ulcer; stomach; duodenum; outcomes; ulcer complications; rofecoxib; celecoxib; cardiovascular coronary artery disease; coronary thrombosis; rheumatoid arthritis; osteoarthritis;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
108
Recensione:
Indirizzi per estratti:
Indirizzo: Hawkey, CJ Univ Nottingham Hosp, Queens Med Ctr, Div Gastroenterol, Nottingham NG7 2UH, England Univ Nottingham Hosp Nottingham England NG7 2UH 2UH, England
Citazione:
C.J. Hawkey, "COX-1 and COX-2 inhibitors", BEST PR RES, 15(5), 2001, pp. 801-820

Abstract

By inhibiting prostaglandin synthesis, non-steroidal anti-inflammatory drugs (NSAIDs) cause mucosal damage, ulceration and ulcer complication throughout the gastrointestinal tract. The recognition that there are two cyclo-oxygenase enzymes, one predominating at sites of inflammation (COX-2) and oneconstitutively expressed in the gastrointestinal tract (COX-1), has led tothe important therapeutic development of COX-2 inhibitors. COX-2 is phylogenetically more primitive that COX-1 and, while very similar, has critical differences, particularly the existence of a small pocket half way down theactive enzyme site. A number of drugs achieve selectivity by binding to this pocket, including presumptively rofecoxib and celecoxib. Others, such asmeloxicam, may inhibit COX-2 by different mechanisms. Truly selective COX-2 inhibitors have been shown to have no effect on gastric mucosal prostaglandin synthesis, to cause no acute injury, and no chronic ulceration compared to placebo. Rofecoxib has, in a prospective systematic evaluation involving 8076 patients, been shown to reduce clinically significant ulcers, ulcer complications and gastrointestinal bleeding significantly compared to naproxen. Outcomes data for celecoxib have also been published although differences from the combined comparator agents (diclofenac and ibuprofen) did not reach statistical significance. Use of aspirin in the class study has shown that the benefits of COX-2 inhibitors may be reduced by aspirin use. The VIGOR study has raised the possibility that some NSAIDs, particularly naproxen, may protect against vascular disease compared to COX-2 inhibitors (or placebo).

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/01/20 alle ore 03:25:30