From Our Archives
New Arthritis Drug - Celebrex
Celebrex is a new medication for the treatment of the inflammation and pain of the two most common forms of arthritis, rheumatoid arthritis and osteoarthritis. Celebrex is classified as a nonsteroidal anti-inflammatory drug (NSAID), however, it is unique in its biologic action compared to previously available drugs of this class.
This article will describe the action of nonsteroidal anti-inflammatory drugs and some of the unique properties of Celebrex. It will then conclude with an in-depth interview of the chief scientist involved in the development and testing of Celebrex.
NSAIDs are taken regularly by approximately 33 million Americans!
The annual risk of serious complications is 1%-4% with chronic NSAID treatment. The risk of complications is higher in elderly patients, rheumatoid arthritis sufferers, patients taking blood thinning medications (anticoagulants such as Coumadin and heparin) or prednisone (cortisone medication), and patients with heart disease or a prior history of bleeding ulcers.
How do NSAIDs cause stomach ulcers and bleeding?
What is the basic difference between traditional
NSAIDs and the newly designed COX-2 inhibitors?
Another enzyme, cyclooxygenase-2 (COX-2), also produces these chemical messenger molecules, but the COX-2 enzyme is located specifically in areas of the body that are responsible for inflammation and not in the stomach. When the COX-2 enzyme is blocked, inflammation is reduced. Since the COX-2 enzyme does not play a role in the normal function of the stomach or intestinal tract, medications which selectively block COX-2 do not present the risk of injuring the stomach or intestines.
Newly developed drugs that selectively block the COX-2 enzyme are called COX-2 inhibitors. Blocking this enzyme impedes the production of the prostaglandins that cause the pain and swelling of arthritis inflammation. The common anti-inflammatory drugs (like Aspirin, ibuprofen, and naproxen) all act by blocking the action of both the COX-1 and COX-2 enzymes.
The COX-2 inhibitors represent a new class of drugs that do not affect COX-1, but selectively block only COX-2. This selective action provides the benefits of reducing inflammation without irritating the stomach. These drugs pose a significant advantage in comparison to previous anti- inflammatory drugs in that they carry nowhere near the risk of stomach ulceration and bleeding. The COX-2 inhibitors are now on the market in the form of celecoxib (Celebrex). It is widely expected that COX-2 inhibitors will be of great value to people with arthritis.