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What is the advantage of COX-2 inhibitors over NSAIDs?

Grant Cooper, MD
Physical Medicine & Rehabilitation
The basic mechanism of action of the COX-2 inhibitors is similar to that of nonsteroidal anti-inflammatory drugs (NSAIDs). Traditional NSAIDs block two enzymes, COX-1 and COX-2. The COX-2 enzyme is the one that needs to be blocked in order to inhibit inflammation. Unfortunately, the lining of the stomach can be damaged when the COX-1 enzyme is also blocked. There is also the potential for kidney damage and high blood pressure when the COX-1 enzyme is blocked.

Initially, it was believed that selectively blocking the COX-2 enzyme would diminish these side effects. In addition, because the COX-1 enzyme would not be blocked, it would be possible to take a higher dosage of the COX-2 blocker, and thus achieve greater control of inflammation and pain. This worked well in laboratory studies, and also in early human studies.
The Arthritis Handbook: Improve Your Health and Manage the Pain of Osteoarthritis (A DiaMedica Guide to Optimum Wellness)

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The Arthritis Handbook: Improve Your Health and Manage the Pain of Osteoarthritis (A DiaMedica Guide to Optimum Wellness)

According to conventional wisdom, arthritis pain is an inevitable part of aging. Not so, says Dr. Grant Cooper in this practical, accessible guide. For those who do develop osteoarthritic conditions,...

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