새로운 COX-2 억제제

Abstract

COX-2 억제제는 뛰어난 염증 억제 및 진통 효과와 함께위장관계 부작용과 출혈 경향은 낮은 비교적 안전한 약제로현재 다양한 상황에 널리 이용되고 있다. 그러나 이미 몇몇의 COX-2 억제제는 심혈관계 부작용으로 인하여 시장에서철수되었고, 나머지의 COX-2 억제제 또한 장기적인 안전성에 있어 자유롭지 못하다.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat pain and inflammation. There are two kinds of NSAID classified according to the selectivity of COX-2 inhibition: non-selective NSAIDs and cyclooxygenase (COX)-2 inhibitors. Non-selective NSAIDs have a high incidence of gastrointestinal and bleeding-associated adverse events, while COX-2 inhibitors are safer in terms of these events. However, COX-2 inhibitors are thought to cause increased cardiovascular events. The COX-2 inhibitors rofecoxib and valdecoxib were withdrawn from the market over safety concerns. Three COX-2 inhibitors are now available in South Korea after the recent approval of etoricoxib and polmacoxib for osteoarthritis patients. After reviewing the history of and recent studies about the safety of COX-2 inhibitors, physicians should find new uses for old drugs.