Although COX-2 selectivity is a likely contributor to the higher CV risk seen with NSAID use, it is not the only factor, given that a higher CV risk has been seen with both coxibs
as well as tNSAIDs.
and traditional NSAID Trialists' (CNT) Collaboration, Bhala N, Emberson J, Merhi A, Abramson S, Arber N, Baron JA, et al.
In canines Coxibs
have been used more frequently for hip arthrosis treatment (2, 9, 12).
It is therefore imperative that further research be done to determine if conventional coxibs
are reliable enough to replace traditional NSAIDs as first-line agents.
Acredita-se que as diferencas nas estruturas quimicas dos coxibs
sejam os fatores determinantes para seu perfil farmacologico, porem a relacao entre doses e efeitos adversos tem mostrado linearidade comum a todos os coxibs
, o que leva ao questionamento de seu papel na terapia anti-inflamatoria e analgesica, uma vez que sua eficacia e similar aos AINE nao seletivos.
This puts the heart risks of generic NSAIDs on a par with a newer class of NSAIDs known as COX-2 inhibitors or coxibs
, which includes Vioxx a painkiller that U.
A new generation of NSAID painkillers known as coxibs
were introduced, which had a lesser risk of stomach pains, but they were widely linked to an increase in heart attacks, leading to public concern and withdrawal of the popular drug Vioxx from shelves in 2004.
are effective in perioperative analgesics for a variety of surgical procedures and presents morphinesparring effects from 30% to 50% (55).
Drugs known to have cardiac effects were included, notably the coxibs
and tricyclic antidepressants.
Adequacy of safety data reporting in randomized clinical trials comparing coxibs
with non selective NSAIDs.
Although prescription painkillers account for 230 million prescription purchases annually, little is known about the comparative safety of these drugs, except for the cardiovascular safety of nsNSAIDs and coxibs
, note the researchers.
The theory underlying the development of the coxibs
was that selective COX-2 inhibition would provide analgesia and anti-inflammatory effects without the risks ofgastric bleeding associated with COX-1 inhibition.
There is also an increased risk of thrombotic events, strokes and coronary events, with all NSAIDs, both coxibs
and non-selective NSAID agents, with the possible exception of naproxen.
, a class of NSAIDs, have been widely used for the treatment of acute and chronic inflammation.
Few studies have examined the relative risks of the three major analgesic groups: NSAIDs, opioids, and coxibs
(selective cyclooxygenase-2 inhibitors).