Monthly Update: Pulmonary-Allergy, Dermatological, Gastrointestinal & Arthritis: Inhibitors of inducible cyclo-oxygenase (COX-2): Anti-inflammatory drugs with improved tolerability?

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most widely used drugs in the world. Their therapeutic efficacy as anti-inflammatory, analgesic and anti-pyretic agents is considered to be due to inhibition of cyclo-oxygenase (COX), the enzyme catalysing the synthesis of prostaglandins [1]. This inhibitory action on COX, however, is also mainly responsible for the well-known side-effects of NSAIDs on the gastrointestinal tract and the kidney [2,3]. The discovery that COX exists in two isoenzymatic forms, constitutive (COX-1) and inducible (COX-2), however, has opened up a new approach to the possible development of NSAIDs with improved tolerability [4]. With novel potent compounds already under development, a timely conference was organised in London on 10 - 11 October, 1995, by the William Harvey Research Institute, to consider recent discoveries in this area.