COX2estäjät

COX2estäjät, also known as selective COX-2 inhibitors or coxibs, are a class of nonsteroidal anti-inflammatory drugs (NSAIDs) that selectively inhibit the cyclooxygenase-2 (COX-2) enzyme. This enzyme plays a key role in the production of prostaglandins, which are mediators of inflammation, pain, and fever. Traditional NSAIDs inhibit both COX-1 and COX-2 enzymes. COX-1 is involved in protecting the stomach lining and maintaining kidney function. By selectively targeting COX-2, coxibs aim to reduce inflammation and pain with a potentially lower risk of gastrointestinal side effects compared to non-selective NSAIDs.

The development of COX-2 inhibitors was motivated by the desire to provide effective pain relief and anti-inflammatory benefits while minimizing the gastrointestinal complications, such as ulcers and bleeding, associated with prolonged use of traditional NSAIDs. Several coxibs have been approved and marketed, including celecoxib, etoricoxib, and parecoxib. They are used to treat a variety of conditions, including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute pain, and primary dysmenorrhea.

Despite their perceived gastrointestinal safety advantage, concerns have arisen regarding the cardiovascular safety of some COX-2 inhibitors. Studies and post-marketing surveillance have indicated an increased risk of heart attack and stroke associated with the use of certain coxibs, particularly at higher doses or in patients with pre-existing cardiovascular risk factors. This has led to the withdrawal of some coxib medications from the market and has prompted careful consideration of the risk-benefit profile for individual patients before prescribing these drugs. Ongoing research continues to explore the precise mechanisms underlying their cardiovascular effects and to identify safer alternatives.