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Aug 27, 2001
 |  BioCentury  |  Tools & Techniques

Lesson from COX-2 data-dredging

Although their study methodology precluded solid evidence that selective cyclo-oxygenase-2 inhibitors increase the risk of heart attack, a series of analyses published by physicians at the Cleveland Clinic Foundation has highlighted the need for controlled clinical studies to evaluate the cardiovascular effects of COX-2 products.

COX-2 inhibitors were designed to provide anti-inflammatory properties without gastrointestinal upset or ulceration. This is done by inhibiting COX-2 enzymes, which are expressed primarily in inflamed tissues, without affecting Cox-1 enzymes that are present in many tissues and play a gastroprotective role.

The Journal of the American Medical Association paper looked at two of the four marketed COX-2 inhibitors: Pharmacia Corp. and Pfizer Inc.'s Celebrex celecoxib and Merck and Co. Inc.'s Vioxx rofecoxib. Both are approved to treat osteoarthritis, and Celebrex also is approved to treat rheumatoid arthritis.

Widespread use of the products has raised questions about how they should be used in practice, as the traditional treatments, NSAIDs such as ibuprofen, diclofenac and nabumetone, are known to provide cardioprotective...

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