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Titolo:
COX-2 inhibitors and the cardiovascular system
Autore:
FitzGerald, GA; Cheng, Y; Austin, S;
Indirizzi:
Univ Penn, Sch Med, Dept Pharmacol, Ctr Expt Therapeut, Philadelphia, PA 19104 USA Univ Penn Philadelphia PA USA 19104 Therapeut, Philadelphia, PA 19104 USA
Titolo Testata:
CLINICAL AND EXPERIMENTAL RHEUMATOLOGY
fascicolo: 6, volume: 19, anno: 2001, supplemento:, 25
pagine: S31 - S36
SICI:
0392-856X(200111/12)19:6<S31:CIATCS>2.0.ZU;2-J
Fonte:
ISI
Lingua:
ENG
Soggetto:
NONSTEROIDAL ANTIINFLAMMATORY DRUGS; RHEUMATOID-ARTHRITIS; MICE LACKING; GASTROINTESTINAL TOXICITY; PLATELET ACTIVATION; SELECTIVE INHIBITOR; CYCLOOXYGENASE-2; PROSTACYCLIN; BIOSYNTHESIS; THROMBOXANE;
Keywords:
cyclooxygenase inhibitors; prostacyclin; thromboxane; cardiovascular;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: FitzGerald, GA Univ Penn, Sch Med, Dept Pharmacol, Ctr Expt Therapeut, 153Johnson Pavil,Philadelphia, PA 19104 USA Univ Penn 153 Johnson Pavil Philadelphia PA USA 19104 4 USA
Citazione:
G.A. FitzGerald et al., "COX-2 inhibitors and the cardiovascular system", CLIN EXP RH, 19(6), 2001, pp. S31-S36

Abstract

Cyclooxygenase-2 selective inhibitors (coxibs) represent a new class of non steroidal anti-inflammatory drugs that exhibit preference for inhibition of cyclooxygenase-2 (COX-2), the COX isoform thought to account largely forprostanoid formation in inflammation. We review the divergent incidence ofcardiovascular events derived from the two large clinical trials of coxibs, the Vioxx(R) Gastrointestinal Outcomes Research Trial (VIGOR) and the Celecoxib Long-term Arthritis Safety Study (CLASS), in the context of current understanding of relevant clinical and basic pharmacology. The incidence of cardiovascular events was higher in patients receiving rofecoxib than in those receiving naproxen in VIGOR and did not differ between the groups in CLASS. By contrast, while the primary gastrointestinal (GI)endpoint comparison favored rofecoxib in VIGOR, no significant difference in the incidence of the primary GI endpoint was evident between celecoxib and two NSAID comparators not attained in CLASS. The cardiovascular results in VIGOR may have resulted from chance, a cardioprotective effect of naproxen, or suppression of prostacyclin but not thromboxane on rofecoxib. Differences in cardiovascular outcome between the twotrials may also have resulted either from chance, or from aspects of the trial design (such as the use of aspirin by roughly one-fifth of the participants in CLASS), or from differences in the COX-2 selectivity or other pharmacology of the coxibs. Individuals who warrant low-dose aspirin for cardioprotection may have less likelihood of a GI event if they combine aspirin with rofecoxib, rather than a traditional NSAID. However, evidence addressing directly this hypothesis is currently unavailable. On the other hand, coxib consumption alone does not currently wart-ant initiation of a cardioprotective regimen, such aslow-dose aspirin.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/04/20 alle ore 02:08:47