COX-2 inhibitor


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COX-2 inhibitor

A drug class that relieves inflammation and pain by inhibiting the action of cyclooxygenase-2.

Prostanoids that mediate inflammation, pain, and fever are synthesized through the action of cyclooxygenase-2 (COX-2), an enzyme that is constitutively expressed in the brain but can be induced in other tissues by cytokines. In both osteoarthritis and rheumatoid arthritis, COX-2 inhibitors have been shown to be superior in pain relief to acetaminophen and placebo, and equivalent to nonselective nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen and naproxen. In rheumatoid arthritis, COX-2 inhibitors are not disease-modifying drugs. Because nonselective NSAIDs inhibit not only COX-2 but also inhibit COX-1, which plays a role in platelet aggregation and gastric mucosal protection, their use is associated with a higher risk of gastrointestinal bleeding than that of selective COX-2 inhibitors. Like NSAIDs, however, the selective agents can cause liver and kidney toxicity, fluid retention, and hypertension. One of them (rofecoxib) was withdrawn by the manufacturer after 5 years on the market because of an unacceptably high incidence of heart attack and thrombotic stroke in patients receiving it for 18 months or more. For these reasons and because they are more expensive than NSAIDs, COX-2 inhibitors are indicated chiefly in patients who are at increased risk of gastrointestinal bleeding.

COX-2 inhibitor

n.
Any of a class of nonsteroidal anti-inflammatory drugs that selectively block prostaglandin formation so as to cause minimal gastrointestinal side effects.

COX-2 inhibitor

Cyclooxygenase-2 inhibitor Pain management A class of analgesics with fewer side effects than those of conventional NSAIDs–which inhibit both cyclooxygenases–COX-1 and COX-2; COX-1 protects the gastric mucosa, preventing ulcers, bleeding, and other digestive tract problems. See COX-2, Prostaglandin.

COX-2 in·hib·i·tor

(in-hibi-tŏr)
A drug class that relieves inflammation and pain by inhibiting the action of cyclooxygenase-2.
References in periodicals archive ?
These proxy variables are the percent of all the physician's monthly office visits that are to OA patients and the percent of all the physician's monthly visits to OA patients that are associated with a COX-2 inhibitor prescription, respectively.
Recipients with low to moderate risk for serious GI events were not allowed to receive a COX-2 inhibitor under the PAR program.
Selective" COX-2 inhibitors were developed to avoid the GI complications of traditional NSAIDs, not because they had advantages in terms of pain relief, Antman explained.
COX-2 inhibitors are effective for the reduction of adenomatous polyps.
Data show that since the introduction of COX-2 inhibitors, the rate of
However, profiling requires establishing a benchmark for appropriate cox-2 inhibitor use.
The MEDAL Program provides the first comparison of a selective COX-2 inhibitor and a traditional NSAID to assess the effect of concomitant GI co-therapy with PPI's on long-term risk of upper GI clinical events and upper GI symptoms, and is the largest comparison of these agents in low-dose aspirin users.
COX inhibition by any NSAID or COX-2 inhibitor can be expected to upset the thrombotic equilibrium, increasing the risk of cardiovascular events.
COX-2 inhibitors were initially marketed because they were less likely to cause deadly peptic ulcers.
The bad news is that in a review of the research on the COX-2 inhibitors, it seems they may have the same negative effect on kidney function as older NSAIDs, adversely affecting renal function, disturbing sodium and potassium balance, and impairing the work the kidneys do.
That said, for patients with an average risk for developing colon cancer--those with a few polyps, none of which is larger than 1 cm--the current approach of colonoscopy every 3-5 years without a COX-2 inhibitor is probably the most prudent course.
Known as a COX-2 inhibitor, Bextra belongs to the same class of drugs as rofecoxib (Vioxx), which manufacturer Merck yanked from pharmacy shelves last September after safety risks appeared (SN: 10/30/04, p.