Kawai Shinichi
Institute of Medical Science, St. Marianna University School of Medicine.
Nihon Rinsho. 2002 Dec;60(12):2370-7.
Nonsteroidal anti-inflammatory drugs(NSAIDs) are clinically effective against the inflammatory symptoms of rheumatoid arthritis. Recent attention has been focused on selective cyclooxygenase(COX)-2 inhibitors, a type of NSAID that inhibits a subtype of COX. Because of the different actions of COX-1 and COX-2, selective COX-2 inhibitors were expected to reduce adverse reactions such as gastrointestinal disorders. Various clinical studies have confirmed that the efficacy of COX-2 inhibitors for RA is similar to that of conventional NSAIDs, but they cause fewer severe gastrointestinal disorders. The incidence of complications related to renal dysfunction, such as edema and hypertension, is not different. Patients using selective COX-2 inhibitors have recently been reported to show an increase in thrombotic complications such as myocardial infarction. Therefore, more data on adverse events should be collected in the future from large-scale clinical studies to further clarify the actual value of selective COX-2 inhibitors.
非甾体抗炎药（NSAIDs）在临床上对类风湿性关节炎的炎症症状有效。最近的注意力集中在选择性环氧化酶（COX）-2抑制剂上，这是一种抑制COX亚型的NSAID。由于COX-1和COX-2的作用不同，选择性COX-2抑制剂有望减少诸如胃肠道疾病等不良反应。各种临床研究证实，COX-2抑制剂对类风湿性关节炎的疗效与传统NSAIDs相似，但它们引起的严重胃肠道疾病较少。与肾功能不全相关的并发症（如水肿和高血压）的发生率没有差异。最近有报道称，使用选择性COX-2抑制剂的患者出现血栓形成并发症（如心肌梗死）的情况有所增加。因此，未来应从大规模临床研究中收集更多关于不良事件的数据，以进一步阐明选择性COX-2抑制剂的实际价值。
