[Non-steroidal antiinflammatory drug--management of gastrointestinal complications and inhibition of COX-2].

Non-steroidal antiinflammatory drugs (NSAID) are widely used for the treatment of rheumatoid arthritis and other collagen vascular diseases, and now more than 30 drugs are available. However, caution should be paid in using NSAIDs because of their serious side effects, especially gastrointestinal toxicity. Misoprostol has been shown to prevent NSAID-induced gastrointestinal damage, and proton-pump inhibitor omeprazole and misoprostol have been shown to be effective in the treatment of ulcers and erosions induced by NSAIDs. After the discovery of cyclooxygenase-2 (COX-2), investigators have raised a hypothesis that specific inhibitor of COX-2 should have anti-inflammatory activity with least gastrointestinal toxicity. According to this, efforts have been paid to produce COX-2 selective inhibitors. Although several COX-2 inhibitors have been reported to show reduced toxicity, further investigations are needed to establish their usefulness.