In this issue of the Journal, Title et al. (1) present the results of the much-awaited randomized double-blind evaluation of rofecoxib on endothelial function in patients with coronary artery disease (CAD). From a cardiovascular standpoint, cyclooxygenase-2 (COX-2) inhibitors have been the topic of much discussion, debate, and trepidation (2–5). Mechanistically, the concern about the use of the...

For about two years, selective inhibitors of cyclooxygenase-2 have been hailed as powerful additions to the armamentarium of nonsteroidal anti-inflammatory drugs (NSAIDs). Predicted by financial analysts to become among the pharmaceutical industry's greatest-ever blockbusters, two so-called coxibs are now widely utilized clinically: rofecoxib (Vioxx, Merck) and celecoxib (Celebrex, Monsanto). T...

BACKGROUND Rofecoxib and celecoxib (coxibs) effectively treat chronic arthritis pain and reduce ulcer complications by 50% compared with nonselective nonsteroidal anti-inflammatory drugs (NSAIDs). However, their absolute risk reduction is small and the cost-effectiveness of treatment is uncertain. OBJECTIVE To determine whether the degree of risk reduction in gastrointestinal complications by...

The new generation of analgesics and antiinflammatory drugs, namely, the selective inhibitors of cyclooxygenase–2 (COX-2) enzymes, popularly known as Coxibs, have become a very popular class of drugs because of their gastro-sparing property. Coxibs were the widely prescribed drugs (nearly 8 million people round the globe take these drugs) until the recent setback with rofecoxib, which was withd...

BACKGROUND AND OBJECTIVES Due to the high incidence of NSAID-related side-effects, the discovery of two cycloxygenase isoforms, classified as: COX-1 or constitutive and COX-2 or inductive, has formulated the paradigm that NSAIDs anti-inflammatory properties would be mediated by COX-2 inhibition, and side-effects, by COX-1 blockade. However, COX-2 has been constitutively detected in normal tissu...

Since their approval in 1998, the popularity of selective cyclooxygenase-2 (COX2) inhibitors has swung from a domination of drug sales to serious disputes about their cardiovascular safety. Despite the numerous studies on COX2 inhibitors that have emerged, drawing conclusions about their cardiovascular safety has been complicated by conflicting results, underpowered clinical trials, and the lac...

J Cotter and Eric Wooltorton highlight the importance of differences in cyclooxygenase 2 (COX-2) selectivity as a potential explanation for the prothrombotic effects of coxibs. However, they neglect important evidence that celecoxib might not share the same cardiovascular (CV) risk as rofecoxib. An increased thrombotic risk with celecoxib has been demonstrated only in the APC (Adenoma Preventio...

Coxibs are a group of non-steroidal anti-inflammatory drugs (NSAIDs), selective cyclooxygenase 2 inhibitors, characterized by much lower gastrotoxicity compared to classic NSAIDs. They often used in conjunction with other drugs, which greatly increases the likelihood adverse drug interactions. The presented study analyzed degradation rate celecoxib and cimicoxib solutions under influence medici...