Future of COX2 inhibitors

Prostaglandins and bone: potential risks and benefits related to the use of nonsteroidal anti-inflammatory drugs in clinical dentistry

“…These medicaments -celecoxib (Celebrex ® , Pfizer, New York, USA), rofecoxib (Vioxx ® , Merck, New Jersey, USA) and valdecoxib (Bextra ® , Pfizer) -have anti-inflammatory effects that are at least comparable to conventional NSAIDs, but with less gastrointestinal toxicity. They were made available for use in 1999 (6), with the promise of solving the morbidity associated with prolonged NSAID use.…”

“…Thus, although COX-2 inhibitors proved to be clinically effective against certain chronic inflammatory diseases and in reducing the incidence of gastrointestinal lesions, prolonged use has unexpectedly caused a significant increase in the incidence of thrombosis and myocardial infarcts (1,6).…”

Efeito dos anti-inflamatórios não-esteroidais convencionais e seletivos para COX-2 sobre o reparo ósseo

“…With the discovery of the type 2 of COX, in 1991, pharmaceutical industry started to massively invest in the development of COX-2-selective NSAIDs, pursuing a powerful therapeutic action but without the undesired side effects. These drugs -known as coxibs -were first introduced to the market in 1999 (5) , providing an effective anti-inflammatory action and significantly lower risks of gastrointestinal toxicity as compared to conventional NSAIDs, promising a solution for the COX-2 stimulation, in controlling bone formation, the results regarding the potential inhibitory effects of selective NSAIDs on experimental bone healing are still controversial and there is no clinical data to confirm that they interfere negatively with repairing bone formation.…”

“…More recently, the long-term use of selective cox-2 inhibitors have been emerging also as a preventive and therapeutic alternative for some non-inflammatory diseases that result in increased COX-2 expression, as seen in some kinds of cancer, notably those of epithelial source, and in Alzheimer's disease (2) . Nevertheless, the long-term use of some of these selective NSAIDs has been shown to be deleterious to renal function and homeostasis, offering an increased risk of thrombosis and infarction (5) . (5) .…”

“…Nevertheless, the long-term use of some of these selective NSAIDs has been shown to be deleterious to renal function and homeostasis, offering an increased risk of thrombosis and infarction (5) . (5) .…”