Experimental and clinical pharmacology: COX-2 inhibitors

There are two cyclo-oxygenase enzymes: COX-1 regulates physiological function in the gut and kidney, while COX-2 is induced in inflammation and repair. Selective COX-2 inhibitors are now available. In early clinical trials their efficacy in arthritis was equivalent to that of less selective non-steroidal anti-inflammatory drugs and they had a significantly lower incidence of gastrointestinal adverse effects. Larger and longer outcome studies are awaited to address issues such as a possible delaying effect of COX-2 inhibitors on ulcer healing and the potential for adverse cardiovascular effects