Does a coxib-associated thrombotic risk limit the clinical use of the compounds as analgesic, antiinflammatory drugs?

Artur-Aron Weber; Thomas Hohlfeld; Sebastian Harder

doi:10.1160/TH06-08-0445

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2006; 96(04): 413-416
DOI: 10.1160/TH06-08-0445

Theme Issue Article

Schattauer GmbH

Does a coxib-associated thrombotic risk limit the clinical use of the compounds as analgesic, antiinflammatory drugs?

Arguments against

Artur-Aron Weber

¹Institut für Pharmakologie und Klinische Pharmakologie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany

,

Thomas Hohlfeld

¹Institut für Pharmakologie und Klinische Pharmakologie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany

,

Sebastian Harder

²Institut für Klinische Pharmakologie, Johann-Wolfgang Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany

› Author Affiliations

Abstract

Summary

The issue of the risk-benefit assessment of cyclooxygenase-2 (COX-2) inhibitors, as compared to traditional non-steroidal anti-inflammatory drugs (tNSAIDs), is far from being resolved. These compounds need to be carefully re-evaluated in order to avoid hasty conclusions, as it happened when COX-2 inhibitors were introduced into clinical practice. Several arguments support the concept, that COX-2 inhibitors remain a valuable therapeutic option at least for selected patients.

Keywords

Arterial thrombosis - lipid mediators - inflammation - haemostasis - clinical studies

Full Text

References

References
1 Wadman M. How doesa painkiller harm the heart?. Nature 2006; 441: 262.
2 Grosser T, Fries S, FitzGerald G. Biological basis for the cardiovascular consequences of COX-2 inhibition: therapeutic challenges and opportunities. J Clin Invest 2006; 116: 4-15.
3 De Witt. COX-2-selective inhibitors: the new super aspirins. Mol Pharmacol 1999; 55: 625-31.
4 Dai C, Stafford RS, Alexander GC. National trends in cyclooxygenase-2 inhibitor use since market release: non-selective diffusion of a selectively cost-effective innovation. Arch Intern Med 2005; 165: 171-7.
5 Chan FK, Hung LC, Suen BY. et al. Celecoxib versus diclofenac and omeprazole in reducing the risk of recurrent ulcer bleeding in patients with arthritis. N EnglJ Med 2002; 347: 2104-10.
6 Chan FK, LCT Hung, BY Suen. et al. Celecoxib versus diclofenac plus omeprazole in high-risk arthritis patients: Results of a randomized double-blind trial. Gastroenterology 2004; 127: 1038-43.
7 Scheinmann JM, Yeomans ND, Talley NJ. et al. Prevention of ulcers by esomeprazole in at-risk patients using non-selective NSAIDs and COX-2 inhibitors. Am J Gastroenterol 2006; 101: 701-10.
8 Solomon SD, McMurray JJ, Pfeffer MA. et al. for the Adenoma Prevention with Celecoxib (APC) Study Investigators. Cardiovascular risk associated with celecoxib in a clinical trial for colorectal adenoma prevention. N Engl J Med 2005; 352: 1071-80.
9 Bresalier RS, Sandler RS, Quan H. et al. for the Adenomatous Polyp Prevention on Vioxx (APPROVe) Trial Investigators. Cardiovascular events associated with rofecoxib in a colorectal adenoma chemoprevention trial. N Engl J Med 2005; 352: 1092-102.
10 Kearney PM, Baigent C, Godwin J. et al. Do selective cyclo-oxygenase-2 inhibitors and traditional non-steroidal anti-inflammatory drugs increase the risk of atherothrombosis? Meta-analysis of randomised trials. Br Med J 2006; 332: 1302-8.
11 Mamdani M, Rochon P, Juurlink DN. et al. Effect of selective cyclooxygenase2 inhibitors and naproxen on short-term risk of acute myocardial infarction in the elderly. Arch Intern Med 2003; 163: 481-6.
12 Kimmel SE, Berlin JA, Reilly M. et al. Patients exposed to rofecoxib and celecoxib have different odds of nonfatal myocardial infarction. Ann Intern Med 2005; 142: 157-64.
13 Graham DJ, Campen D, Hui R. et al. Risk of acute myocardial infarction and sudden cardiac death in patients treated with cyclo-oxygenase 2 selective and non-selective non-steroidal anti-inflammatory drugs: nested case-control study. Lancet 2005; 365: 475-81.
14 Hippisley-Cox J, Coupoland C. Risk of myocardial infarction in patients taking cyclo-oxygenase-2 inhibitors or conventional non-steroidal anti-inflammatory drugs: population based nested case-control analysis. Br Med J 2005; 330: 1366-70.
15 Johnsen SP, Larsson H, Tarone RE. et al. Risk of hospitalization for myocardial infarction among users of rofecoxib, celecoxib, and other NSAIDs: a population-based case-control study. Arch Intern Med 2005; 165: 978-84.
16 Farkouh ME, Kirshner H, Harrington RA. et al. on behalf of the TARGET Study Group. Comparison of lumiracoxib with naproxen and ibuprofen in the Thera- peutic Arthritis Research and Gastrointestinal Event Trial (TARGET), cardiovascular outcomes: randomised controlled trial. Lancet 2004; 364: 675-84.
17 Helin-Salmivaara A, Virtanen A, Vesalainen R. et al. NSAID use and the risk of hospitalization for first myocardial infarction in the general population: a nationwide case-control study from Finland. Eur HeartJ 2006; 27: 1657-63.
18 Hawkey CJ, Hawkey GM, Everitt S. et al. Increased risk of myocardial infarction as first manifestation of ischaemic heart disease and nonselective nonsteroidal anti-inflammatory drugs. Br J Clin Pharmacol 2006; 61: 730-7.
19 Fischer LM, Schlienger RG, Matter CM. et al. Dis-continuation of nonsteroidal anti-inflammatory drug therapy and risk of acute myocardial infarction. Arch Intern Med 2004; 164: 2472-6.
20 Smyth EM, Burke A, FitzFerald GA. Lipid-derived autacoids: Eisosanoids and platelet-activating factor. In: Brunton LL, Lazo JS, Parker KL. The Pharmacological Basis of Therapeutics. 11th ed.. McGraw-Hill; New York: 2005: 653-70.
21 Catella-Lawson F, Reilly M, Kapoor SC. et al. Cyclooxygenase inhibitors and the antiplatelet effects of aspirin. N Engl J Med 2001; 345: 1809-17.
22 Fiorucci S, Distrutti E, de Lima OM. et al. Relative contribution of acetylated cyclooxgenase (COX)-2 and 5-lipoxygenase (LOX) in regulating gastric mucosal integrity and adaptation to aspirin. FASEB J 2003; 17: 1171-3.
23 CAPRIE Steering Committee. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). Lancet 1996; 348: 1329-39.