Osteoarthritis, treatment cyclooxygenase-2 inhibitors

FIGURE 2-1. Treatment for osteoarthritis. (COX, cyclooxygenase IA, intraarticular NSAID, nonsteroidal antiinflammatory drug OA, osteoarthritis PPI, proton pump inhibitor.)... 

The so-called COX (cyclooxygenase) inhibitors are widely applied in the treatment of acute and chronic pain and inflammation, that is, in rheumatoid arthritis and osteoarthritis. The characterization of the correlation between the plasma concentration of COX inhibitors and their pain- and inflammation-decreasing ability is often done via inflammation biomarkers such as PGE2 and thromboxane B2. 

Bensen WG, Fiechtner JJ, McMillen JI, Zhao WW, Yu SS, Woods EM, Hubbard RC, Isakson PC, Verburg KM, Geis GS. Treatment of osteoarthritis with celecoxib, a cyclooxygenase-2 inhibitor a randomized controlled trial. Mayo Clin Proc 1999 74(11) 1095-105. 

Celecoxib is a selective COX-2 inhibitor/GI agent that reduces inflammation (e.g., pain, redness, swelling, heat), fever, and pain by inhibiting chemicals in the body that cause inflammation, fever, and pain. This is probably caused by the inhibition of prostaglandin synthesis, primarily via inhibition of cyclooxygenase-2 (COX-2) isoenzyme. Celecoxib is indicated in relief of symptoms of osteoarthritis relief of symptoms of rheumatoid arthritis in adults management of acute pain in adults treatment of primary dysmenorrhea and reduction of the number of adenomatous colorectal polyps in familial adenomatous polyposis (FAP), as an adjunct to usual care (e.g., endoscopic surveillance, surgery). 

Etoricoxib is a selective cyclooxygenase (COX-2) inhibitor, approved in Europe for the symptomatic treatment of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis and acute gouty arthritis. Etoricoxib does not have Food and Drug Administration approval. 

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