Skip to main content

Efficacy and gastrointestinal safety of selective COX-2 inhibitors

  • Chapter
COX-2 Inhibitors

Part of the book series: Milestones in Drug Therapy MDT ((MDT))

  • 315 Accesses

Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonly prescribed drugs in the world and are used frequently as anti-inflammatory and analgesic agents in the treatment of musculoskeletal conditions. Their use is mainly limited by adverse effects, which are more frequently seen with NSAIDs than with any other prescription drug. These side-effects are of particular importance in the elderly who are more prone to NSAID complications [1].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Girgis L, Brooks P (1994) Nonsteroidal anti-inflammatory drugs. Differential use in older patients. Drugs Aging 4: 101–112

    Article  PubMed  CAS  Google Scholar 

  2. Vane JR (1971) Inhibition of prostaglandin synthesis as a mechanism of action for aspirin-like drugs. Nature 231: 232–235

    CAS  Google Scholar 

  3. Roth GJ, Stanford N, Majerus PW (1975) Acetylation of prostaglandin synthetase by aspirin. Proc Natl Acad Sci USA 72: 3073–3076

    Article  PubMed  CAS  Google Scholar 

  4. Henry D, Lim LL, Garcia-Rodriguez LA, Perez Gutthann S, Carson JL, Griffin M, Savage R, Logan R, Moride Y, Hawkey C et al (1996) Variability in risk of gastrointestinal complications with individual non-steroidal antiinflammatory drugs: results of a collaborative meta-analysis. BMJ 312: 1563–1566

    Article  PubMed  CAS  Google Scholar 

  5. Singh G, Ramey DR, Morfeld D, Fries JF (1994) Comparative toxicity of non-steroidal antiinflammatory agents. Pharmacol Ther 62: 175–191

    Article  PubMed  CAS  Google Scholar 

  6. Langman MJ (1988) Ulcer complications and nonsteroidal anti-inflammatory drugs. Am J Med 84: 15–19

    Article  PubMed  CAS  Google Scholar 

  7. Garcia Rodriguez LA, Jick H (1994) Risk of upper gastrointestinal bleeding and perforation associated with individual non-steroidal anti-inflammatory drugs. Lancet 343: 769–772

    Article  PubMed  CAS  Google Scholar 

  8. MacDonald TM, Morant SV, Robinson GC, Shield MJ, McGilchrist MM, Murray FE, McDevitt DG (1997) Association of upper gastrointestinal toxicity of non-steroidal anti-inflammatory drugs with continued exposure: cohort study. BMJ 315: 1333–1337

    Article  PubMed  CAS  Google Scholar 

  9. Kujubu DA, Fletcher BS, Varnum BC, Lim RW, Herschman HR (1991) TISIO, a phorbol ester tumor promoter-inducible mRNA from Swiss 3 T3 cells, encodes a novel prostaglandin synthase/cyclooxygenase homologue. J Biol Chem 266: 12866–12872

    PubMed  CAS  Google Scholar 

  10. O’Banion MK, Sadowski HB, Winn V, Young DA (1991) A serum-and glucocorticoid regulated 4-kilobase mRNA encodes a cyclooxygenase-related protein. J Biol Chem 266: 23261–23267

    PubMed  Google Scholar 

  11. Simmons DL, Levy DB, Yannoni Y, Erikson RL (1989) Identification of an ester repressible v-srcinducible gene. Proc Natl Acad Sci USA 86: 1178–1182

    Article  PubMed  CAS  Google Scholar 

  12. Vane JR, Bakhle YS, Botting RM (1998) Cyclooxygenases 1 and 2. Annu Rev Pharmacol Toxicol 38: 97–120

    Article  PubMed  CAS  Google Scholar 

  13. Warner TD, Giuliano F, Vojnovic I, Bukasa A, Mitchell JA, Vane JR (1999) Nonsteroidal drug selectivities for cyclo-oxygenase-1 rather than cyclo-oxygenase-2 are associated with human gastrointestinal toxicity: a full in vitro analysis. Proc Natl Aca Sci USA 96: 7563–7568

    Article  CAS  Google Scholar 

  14. Brooks P, Emery P, Evans J, Fenner H, Hawkey CJ, Patrono C, Smolen J, Breedveld F, Day R, Dougados M et al (1998) Interpreting the clinical significance of the differential inhibition of cyclooxygenase-1 and cyclooxygenase-2. Br J Rheumatol 27 (Suppl. 1): 118

    Google Scholar 

  15. Donnelly MT, Hawkey CJ (1997) Review article: COX-2 inhibitors – a new generation of safer NSAIDs? Aliment Pharmacol Ther 11: 227–236

    Article  PubMed  CAS  Google Scholar 

  16. Emery P (1996) Clinical implications of selective cyclooxygenase-2 inhibition. Scand J Rheumatol 102 (Suppl 1): 23–28

    Article  CAS  Google Scholar 

  17. Hawkey CJ (1999) COX-2 inhibitors. Lancet 353: 307–314

    Article  PubMed  CAS  Google Scholar 

  18. Hawkey CJ, Lanas AI (2001) Doubt and certainty about nonsteroidal antiinflammatory drugs in the year 2000: a multidisciplinary expert statement. Am J Med 110:S79–S100

    Article  Google Scholar 

  19. Richardson C, Emery P (1996) The clinical implications of inhibition of the inducible form of cyclo-oxygenase. Drug Safety 15: 249–260

    Article  PubMed  CAS  Google Scholar 

  20. Rostom A, Wells G, Tugwell P, Welch V, Dube C, McGowan J (2000) The prevention of chronic NSAID induced upper gastrointestinal toxicity: a Cochrane collaboration metaanalysis of randomized controlled trials. J Rheumatology 27: 2203–2214

    CAS  Google Scholar 

  21. Yeomans ND, Tulassay Z, Juhasz L, Racz I, Howard JM, van Rensburg CJ, Swannell AJ, Hawkey CJ (1998) A comparison of omeprazole with ranitidine for ulcers associated with nonsteroidal antiinflammatory drugs. Acid Suppression Trial: Ranitidine versus Omeprazole for NSAID-associated Ulcer Treatment (ASTRONAUT) Study Group. N Engl J Med 338: 719–726

    Article  PubMed  CAS  Google Scholar 

  22. Hawkey CJ, Karrasch JA, Szczepanski L, Walker DG, Barkun A, Swannell AJ, Yeomans ND (1998) Omeprazole compared with misoprostol for ulcers associated with nonsteroidal antiinflammatory drugs. Omeprazole versus Misoprostol for NSAID-induced Ulcer Management (OMNIUM) Study Group. N Engl J Med 338: 727–734

    Article  PubMed  CAS  Google Scholar 

  23. McCarthy DM (1991) Sucralfate. N Engl J Med 325: 1017–1025

    Article  PubMed  CAS  Google Scholar 

  24. Emery P (1999) COX-1, COX-2: So what? Scand J Rheumatol 28: 6–9

    Article  PubMed  CAS  Google Scholar 

  25. Tomasoni S, Noris M, Zappella S, Gotti E, Casiraghi F, Bonazzola S, Benigni A, Remuzzi G (1998) Upregulation of renal and systemic cyclooxygenase-2 in patients with active lupus nephritis. J Am Soc Nephrol 9: 1202–1212

    PubMed  CAS  Google Scholar 

  26. Lund B, Distel M, Bluhmki E (1998) A double-blind, randomized, placebo-controlled study of efficacy and tolerance of meloxicam treatment in patients with osteoarthritis of the knee. Scand J Rheumatol 27: 32–37

    Article  PubMed  CAS  Google Scholar 

  27. Yocum D, Fleischmann R, Dalgin P, Caldwell J, Hall D, Roszko P (2000) Safety and efficacy of meloxicam in the treatment of osteoarthritis: a 12-week, double-blind, multiple-dose, placebo-controlled trial. Arch Intern Med 160: 2947–2954

    Article  PubMed  CAS  Google Scholar 

  28. Linden B, Distel M, Bluhmki E (1996) A double-blind study to compare the efficacy and safety of meloxicam 15 mg with piroxicam 20 mg in patients with osteoarthritis of the hip. Br J Rheumatol 35 (Suppl 1): 35–38

    Article  PubMed  CAS  Google Scholar 

  29. Furst DE, Kolba KS, Fleischmann R, Silverfield J, Greenwald M, Roth S, Hall DB, Roszko PJ (2002) Dose response and safety study of meloxicam up to 22.5 mg daily in rheumatoid arthritis: a 12 week multicenter, double blind, dose response study versus placebo and diclofenac. J Rheumatol 29: 436–446

    CAS  Google Scholar 

  30. Lemmel EM, Bolten W, Burgos-Vargas R, Platt P, Nissila M, Sahlberg D, Bjorneboe 0, Baumgartner H, Valat JP, Franchimont P et al (1997) Efficacy and safety of meloxicam in patients with rheumatoid arthritis. J Rheumatol 24: 282–290

    PubMed  CAS  Google Scholar 

  31. Wojtulewski JA, Schattenkirchner M, Barcelo P, Le Loet X, Bevis PJR, Bluhmki E, Distel M (1996) A six-month double-blind trial to compare the efficacy and safety of meloxicam 7.5 mg daily and naproxen 750 mg daily in patients with rheumatoid arthritis. Br J Rheumatol 35 (Suppl 1): 22–28

    Article  PubMed  CAS  Google Scholar 

  32. Dougados M, Gueguen A, Nakache JP, Velicitat P, Veys EM, Zeidler H, Calin A (1999) Ankylosing spondylitis: what is the optimum duration of a clinical study? A one year versus a six weeks non-steroidal anti-inflammatory drug trial. Rheumatology 38: 235–244

    Article  PubMed  CAS  Google Scholar 

  33. Simon LS, Weaver AL, Graham DY, Kivitz AJ, Lipsky PE, Hubbard RC, Isakson PC, Verburg KM, Yu SS, Zhao WW et al (1999) Anti-inflammatory and upper gastrointestinal effects of celecoxib in rheumatoid arthritis: a randomized controlled trial. JAMA 282: 1921–1928

    Article  PubMed  CAS  Google Scholar 

  34. Bensen WG, Fiechtner JJ, McMillen JI, Zhao WW, Yu SS, Woods EM, Hubbard RC, Isakson PC, Verburg KM, Geis GS (1999) Treatment of osteoarthritis with celecoxib, a cyclooxygenase-2 inhibitor: a randomized controlled trial. Mayo Clin Proc 74: 1095–1105

    Article  PubMed  CAS  Google Scholar 

  35. McKenna F, Borenstein D, Wendt H, Wallemark C, Lefkowith JB, Geis GS (2001) Celecoxib ver- sus diclofenac in the management of osteoarthritis of the knee. Scand J Rheumatol 30: 11–18

    Article  PubMed  CAS  Google Scholar 

  36. Williams GW, Hubbard RC, Yu SS, Zhao W, Geis GS (2001) Comparison of once-daily and twice-daily administration of celecoxib for the treatment of osteoarthritis of the knee. Clin Ther 23: 213–227

    Article  PubMed  CAS  Google Scholar 

  37. Zhao S, McMillen JI, Markenson JA, Dedhiya SD, Zhao WW, Osterhaus JT, Yu SS (1999) Evaluation of the functional status aspects of health-related quality of life of patients with osteoarthritis treated with celecoxib Pharmacotherapy 19: 1269–1278

    Article  PubMed  CAS  Google Scholar 

  38. Acevedo E, Castafieda 0, Ugaz M, Beaulieu AD, Pons-Estel B, Caeiro F, Casas N, GarzaElizondo M, Irazoque F, Hinojosa W et al (2001) Tolerability profiles of rofecoxib (Vioxx) and Arthrotec. A comparison of six weeks treatment in patients with osteoarthritis. Scand J Rheumatol 30: 19–24

    Article  PubMed  CAS  Google Scholar 

  39. Cannon GW, Caldwell JR, Holt P, McLean B, Seidenberg B, Bolognese J, Ehrich E, Mukhopadhyay S, Daniels B (2000) Rofecoxib, a specific inhibitor of cyclooxygenase 2, with clinical efficacy comparable with that of diclofenac sodium: results of a one-year, randomized, clinical trial in patients with osteoarthritis of the knee and hip. Arthritis Rheum 43: 978–987

    Article  PubMed  CAS  Google Scholar 

  40. Day R, Morrison B, Luza A, Castaneda O, Strusberg A, Nahir M, Helgetveit KB, Kress B, Daniels B, Bolognese J et al (2000) A randomized trial of the efficacy and tolerability of the COX-2 inhibitor rofecoxib vs ibuprofen in patients with osteoarthritis. Arch Intern Med 160: 1781–1787

    Article  PubMed  CAS  Google Scholar 

  41. Ehrich EW, Schnitzer TJ, Mcllwain H, Levy R, Wolfe F, Weisman M, Zeng Q, Morrison B, Bolognese J, Seidenberg B et al (1999) Effect of specific COX-2 inhibition in osteoarthritis of the knee: a 6 week double blind, placebo controlled pilot study of rofecoxib. J Rheumatol 26: 2438–2447

    PubMed  CAS  Google Scholar 

  42. Geba GP, Weaver AL, Polis AB, Dixon ME, Schnitzer TJ. Vioxx, Acetaminophen, Celecoxib Trial (VACT) Group (2002) Efficacy of rofecoxib, celecoxib, and acetaminophen in osteoarthritis of the knee: a randomized trial. JAMA 287: 64–71

    Article  PubMed  CAS  Google Scholar 

  43. Saag K, van der HD, Fisher C, Samara A, DeTora L, Bolognese J, Sperling R, Daniels B (2000) Rofecoxib, a new cyclooxygenase 2 inhibitor, shows sustained efficacy, comparable with other nonsteroidal anti-inflammatory drugs: a 6-week and a 1-year trial in patients with osteoarthritis. Arch Fam Med 9: 1124–1134

    Article  PubMed  CAS  Google Scholar 

  44. Truitt KE, Sperling RS, Ettinger WH, Jr, Greenwald M, DeTora L, Zeng Q, Bolognese J, Ehrich E (2001) A multicenter, randomized, controlled trial to evaluate the safety profile, tolerability, and efficacy of rofecoxib in advanced elderly patients with osteoarthritis. Aging Clin Experiment Res 13: 112–121

    CAS  Google Scholar 

  45. Li Q (1999) Statistical Review – NDA 21–042 – Rofecoxib. NDA 21–042.http://www.fda.gov/cder/foi/nda/99/02104252_Vioxx.htm. Accessed Dec. 10, 2003

    Google Scholar 

  46. Schnitzer T, Truitt K, Fleischmann R, Dalgin P, Block J, Zeng Q, Bolognese J, Seidenberg B, Ehrich EW (1999) The safety profile, tolerability, and effective dose range of rofecoxib in the treatment of rheumatoid arthritis. Clin Ther 21: 1688–1702

    Article  PubMed  CAS  Google Scholar 

  47. Catella-Lawson F, McAdam B, Morrison BW, Kapoor S, Kujubu D, Antes L, Lasseter KC, Quan H, Gertz BJ, FitzGerald GA (1999) Effects of specific inhibition of cyclooxygenase-2 on sodium balance, hemodynamics, and vasoactive eicosanoids. J Pharmacol Exp Ther 289: 735–741

    PubMed  CAS  Google Scholar 

  48. Degner F, Richardson B (2001) Review of gastrointestinal tolerability and safety of meloxicam. Inflammopharmacology 9: 71–80

    Article  CAS  Google Scholar 

  49. Hawkey C, Kahan A, Steinbruck K, Alegre C, Baumelou E, Begaud B, Dequeker J, Isomaki H, Littlejohn G, Mau Jet al (1998) Gastrointestinal tolerability of meloxicam compared to diclofenac in osteoarthritis patients. Meloxicam Large-Scale International Study Safety Assessment (MELISSA). Br J Rheumatol 37: 937–945

    Article  PubMed  CAS  Google Scholar 

  50. Dequeker J, Hawkey C, Kahan A, Steinbruck K, Alegre C, Baumelou E, Begaud B, Isomaki H, Littlejohn G, Mau J (1998) Improvement in gastrointestinal tolerability of the selective cyclooxygenase (COX)-2 inhibitor, meloxicam, compared with piroxicam: results of the Safety and Efficacy Large- Scale Evaluation of COX-inhibiting Therapies (SELECT) trial in osteoarthritis. Br J Rheumatol 37: 946–951

    Article  PubMed  CAS  Google Scholar 

  51. Zeidler H, Kaltwasser JP, Leonard JP, Kohlmann T, Sigmund R, Degner F, Hettich M (2002) Prescription and tolerability of meloxicam in day-to-day practice: postmarketing observational cohort study of 13,307 patients in Germany. J Clin Rheumatol 8: 305–315

    Article  PubMed  Google Scholar 

  52. Layton D, Heeley E, Hughes K, Shakir SA (2003) Comparison of the incidence rates of selected gastrointestinal events reported for patients prescribed rofecoxib and meloxicam in general practice in England using prescription-event monitoring data. Rheumatology 42: 622–631

    Article  PubMed  CAS  Google Scholar 

  53. Rinder HM, Tracey JB, Souhrada M, Wang C, Gagnier RP, Wood CC (2002) Effects of meloxicam on platelet function in healthy adults: a randomized, double-blind, placebo-controlled trial. J Clin Pharmacol 42: 881–886

    Article  PubMed  CAS  Google Scholar 

  54. Hawkey C, LaMe L, Simon T, Beaulieu A, Maldonado-Cocco J, Acevedo E, Shahane A, Quan H, Bolognese J, Mortensen E (2000) Comparison of the effect of rofecoxib (a cyclooxygenase 2 inhibitor), ibuprofen, and placebo on the gastroduodenal mucosa of patients with osteoarthritis: a randomized, double-blind, placebo-controlled trial. The Rofecoxib Osteoarthritis Endoscopy Multinational Study Group. Arthritis Rheum 43: 370–377

    Article  PubMed  CAS  Google Scholar 

  55. Laine L, Harper S, Simon T, Bath R, Johanson J, Schwartz H, Stern S, Quan H, Bolognese J (1999) A randomized trial comparing the effect of rofecoxib, a cyclooxygenase 2-specific inhibitor, with that of ibuprofen on the gastroduodenal mucosa of patients with osteoarthritis. Gastroenterology 117: 776–783

    Article  PubMed  CAS  Google Scholar 

  56. Bombardier C, LaMe L, Reicin A, Shapiro D, Burgos-Vargas R, Davis B, Day R, Ferraz MB, Hawkey CJ, Hochberg MC et al VIGOR Study Group (2000) Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. N Engl J Med 343: 1520–1528

    Article  PubMed  CAS  Google Scholar 

  57. Division of Gastrointestinal and Coagulation Drug Products (1998) Medical Officer’s Consult Review.http://www.fda.gov/cder/foi/adcomm/98/adac_12198-constilt.pdf. (Accessed Dec. 10, 2003)

    Google Scholar 

  58. Emery P, Zeidler H, Kvien TK, Guslandi M, Naudin R, Stead H, Verburg KM, Isakson PC, Hubbard RC, Geis GS (1999) Celecoxib versus diclofenac in long-term management of rheumatoid arthritis: randomised double-blind comparison. Lancet 354: 2106–2111

    Article  PubMed  CAS  Google Scholar 

  59. Simon LS, Weaver AL, Graham DY, Kivitz AJ, Lipsky PE, Hubbard RC, Isakson PC, Verburg KM, Yu SS, Zhao WW, Geis GS (1999) Anti-inflammatory and upper gastrointestinal effects of celecoxib in rheumatoid arthritis: a randomized controlled trial. JAMA 282: 1921–1928

    Article  PubMed  CAS  Google Scholar 

  60. Goldstein JL, Correa P, Zhao WW, Burr AM, Hubbard RC, Verburg KM, Geis GS (2001) Reduced incidence of gastroduodenal ulcers with celecoxib, a novel cyclooxygenase-2 inhibitor, compared to naproxen in patients with arthritis. Am J Gastroenterol 96: 1019–1027

    Article  PubMed  CAS  Google Scholar 

  61. FDA-Study 21 (1998)http://www.fda.gov/cder/foi/adcomm/98/adac_12198-consult.pdf. Study 21 (Accessed Dec. 10, 2003)

  62. FDA-Study 71 (1998)http://www.fda.govicder/foi/adcomm/98/adac_12198-consult.pdf. Study 71 (Accessed Dec. 10, 2003)

  63. CLASS-12 Month Data (2000)http://www.fda. gov/ohrms/dockets/ac/O I/briefing/ 367761_05gi.doc(Accessed Dec. 10, 2003)

  64. Silverstein FE, Faich G, Goldstein JL, Simon LS, Pincus T, Whelton A, Makuch R, Eisen G, Agrawal NM, Stenson WF et al (2000) Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis: the CLASS study: A randomised controlled trial. Celecoxib Long-term Arthritis Safety Study. JAMA 284: 1247–1255

    Article  PubMed  CAS  Google Scholar 

  65. Chan FK, Hung LC, Suen BY, Wu JC, Lee KC, Leung VK, Hui AJ, To KF, Leung WK, Wong VW et al (2002) Celecoxib versus diclofenac and omeprazole in reducing the risk of recurrent ulcer bleeding in patients with arthritis. N Engl J Med 347: 2104–2110

    Article  PubMed  CAS  Google Scholar 

  66. Silverstein FE, Graham DY, Senior J, Davies HW, Struthers BJ, Bittman RM, Geis GS (1995) Misoprostol reduces serious gastrointestinal complications in patients with rheumatoid arthritis receiving nonsteroidal anti-inflammatory drugs. A randomized, doubleblind, placebo-controlled trial. Ann Intern Med 123: 241–249

    PubMed  CAS  Google Scholar 

  67. Canadian Coordinating Office for Health Technology Assessment (2003) Gastroduodenal ulcers associated with the use of non-steroidal anti-inflammatory drugs: a systematic review of preventive pharmacological interventions. Final Draft January 2003.hup://www.ccohta.ca/publications/pdf/gastroprotective_fr_e.pdf(Accessed Dec. 10, 2003)

    Google Scholar 

  68. FDA – Study 62 (2000)http://www.fda.gov/cder/foi/adcomm/98/adac_12198-consult.pdf. Study 62 (Accessed Dec. 10, 2003)

  69. Goldstein JL, Silverstein FE, Agrawal NM, Hubbard RC, Kaiser J, Maurath CJ, Verburg KM, Geis GS (2000) Reduced risk of upper gastrointestinal ulcer complications with celecoxib, a novel COX-2 inhibitor. Am J Gastroenterol 95: 1681–1690

    Article  PubMed  CAS  Google Scholar 

  70. Singh G, Goldstein J, Bensen W, Agrawal N, Eisen G, Fort J, Bello A, Boots S (2001) SUCCESS-1 in Osteoarthritis (OA) Trial: celecoxib significantly reduces the risk of serious upper GI complications compared to NSAIDs while providing similar efficacy in 13,274 randomized patients. Abstr Perspect 5 (1):http://www.hopkins-arthritis.som.fhmi.edukular2ODlloa-treatments-cox2.html(accessed June 2003)

    Google Scholar 

  71. Langman MJ, Jensen DM, Watson DJ, Harper SE, Zhao PL, Quan H, Bolognese JA, Simon TJ (1999) Adverse upper gastrointestinal effects of rofecoxib compared with NSAIDs. JAMA 282: 1929–1933

    Article  PubMed  CAS  Google Scholar 

  72. Goei The HS, Lund B, Distel MR, Bluhmki E (1997) A double-blind, randomized trial to compare meloxicam 15 mg with diclofenac 100 mg in the treatment of osteoarthritis of the knee. Osteoarthritis Cartilage 5: 283–288

    Article  PubMed  CAS  Google Scholar 

  73. Hosie J, Distel M, Bluhmki E (1997) Efficacy and tolerability of meloxicam versus piroxicam in patients with osteoarthritis of the hip or knee. A six-month double-blind study. Clin Drug Invest 13: 175–184

    Article  CAS  Google Scholar 

  74. Hosie J, Distel M, Bluhmki E (1996) Meloxicam in osteoarthritis: a 6-month, double-blind comparison with diclofenac sodium. Br J Rheumatol 35 (Suppl 1): 39–43

    Article  PubMed  CAS  Google Scholar 

  75. Distel M, Mueller C, Bluhmki E, Fries J (1996) Safety of meloxicam: a global analysis of clinical trials. Br J Rheumatol 35 (Suppl 1): 68–77

    Article  PubMed  CAS  Google Scholar 

  76. Distel M, Mueller C, Bluhmki E (1996) Global analysis of gastrointestinal safety of a new NSAID, meloxicam. Inflammopharmacology 4: 71–81

    Article  CAS  Google Scholar 

  77. National Institute for Clinical Excellence (2001) Guidance on the use of cyclo-oxygenase (COX) II selective inhibitors, celecoxib, rofecoxib, meloxicam and etodolac for osteoarthritis and rheumatoid arthritis. London, UK.http://www.nice.org.uk/article.asp ?a= 18030(accessed June 2003)

    Google Scholar 

  78. Wallace JL, McKnight W, Reuter BK, Vergnolle N (2000) NSAID-induced gastric damage in rats: requirement for inhibition of both cyclooxygenase 1 and 2. Gastroenterology 119: 706–714

    Article  PubMed  CAS  Google Scholar 

  79. McAdam BF, Catella-Lawson F, Mardini IA, Kapoor S, Lawson JA, FitzGerald GA (1999) Systemic biosynthesis of prostacyclin (COX)-2: the human pharmacology of a selective inhibitor of COX-2. Proc Nall Acad Sci USA 96: 272–277

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2004 Springer Basel AG

About this chapter

Cite this chapter

Degner, F. (2004). Efficacy and gastrointestinal safety of selective COX-2 inhibitors. In: Pairet, M., van Ryn, J. (eds) COX-2 Inhibitors. Milestones in Drug Therapy MDT. Birkhäuser, Basel. https://doi.org/10.1007/978-3-0348-7879-1_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-0348-7879-1_5

  • Publisher Name: Birkhäuser, Basel

  • Print ISBN: 978-3-0348-9607-8

  • Online ISBN: 978-3-0348-7879-1

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics