Caporali R, Montecucco C
University of Pavia, IRCCS Policlinico S Matteo, Pavia, Italy.
Lupus. 2005;14(9):785-8. doi: 10.1191/0961203305lu2221oa.
A new class of drugs, the selective cyclooxygenase-2 (COX-2) inhibitors, or coxibs, have recently been marketed as an alternative to conventional nonsteroidal anti-inflammatory drugs (NSAIDs) on the basis of a lower risk of gastrointestinal side effects. The recent withdrawal of rofecoxib, along with safety concerns about other COX-2 selective inhibitors raises important questions about the cardiovascular toxicity of these drugs. Recently some concerns arose even for a possible cardiotoxicity of nonselective nonsteroidal anti-inflammatory drugs. From data available so far, it seems that coxibs still remain a rational choice for patients with low cardiovascular risk and high gastrointestinal risk. Long-term studies with a cardiovascular endpoint involving both selective and nonselective anti-inflammatory drugs are warranted.
一类新型药物，即选择性环氧化酶-2（COX-2）抑制剂或昔布类药物，最近已投放市场，作为传统非甾体抗炎药（NSAIDs）的替代品，其依据是胃肠道副作用风险较低。最近罗非昔布的撤市，以及对其他COX-2选择性抑制剂的安全性担忧，引发了关于这些药物心血管毒性的重要问题。最近甚至对非选择性非甾体抗炎药可能的心脏毒性也产生了一些担忧。从目前可得的数据来看，对于心血管风险低且胃肠道风险高的患者，昔布类药物似乎仍是一个合理的选择。有必要开展涉及选择性和非选择性抗炎药的以心血管终点为指标的长期研究。
