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非甾体抗炎药:皇帝的新教条?

NSAIDs: the emperor's new dogma?

作者信息

Bjarnason I, Takeuchi K, Simpson R

机构信息

Department of Medicine, Guy's, King's, St Thomas' School of Medicine, London, UK.

出版信息

Gut. 2003 Sep;52(9):1376-8. doi: 10.1136/gut.52.9.1376.

Abstract

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.

摘要

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。

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