Bjarnason I, Takeuchi K, Simpson R
Department of Medicine, Guy's, King's, St Thomas' School of Medicine, London, UK.
Gut. 2003 Sep;52(9):1376-8. doi: 10.1136/gut.52.9.1376.
The spectacular marketing success of the selective cyclooxygenase 2 (COX-2) inhibitors is largely based on efficacy comparable with conventional non-steroidal anti-inflammatory drugs (NSAIDs) with vastly improved gastrointestinal safety. The additional key to the marketing success is the purity and simplicity of the message-that is, COX-1 inhibition causes the gastrointestinal side effects of NSAIDs (COX-1 dogma) while COX-2 blocking confers the therapeutic benefits (COX-2 dogma). Adherence to the COX dogmas with development of COX-2 selective agents has undoubtedly benefited many patients, but ironically their scientific basis is now seriously challenged by experimentation.
选择性环氧化酶2（COX-2）抑制剂在市场上取得的巨大成功，很大程度上是基于其疗效与传统非甾体抗炎药（NSAIDs）相当，同时胃肠道安全性有了极大改善。该药物市场成功的另一个关键因素是信息的简洁明了，即COX-1抑制会导致NSAIDs的胃肠道副作用（COX-1教条），而COX-2阻断则带来治疗益处（COX-2教条）。遵循这些COX教条开发COX-2选择性药物无疑使许多患者受益，但具有讽刺意味的是，它们的科学依据现在正受到实验的严峻挑战。
