Rheumatology 1999; 38: 779-788
© 1999 British Society for Rheumatology
Report |
Interpreting the clinical significance of the differential inhibition of cyclooxygenase-1 and cyclooxygenase-2
Faculty of Health Sciences, University of Queensland, Australia,
1 Rheumatology and Rehabilitation Research Unit, Research School of Medicine, University of Leeds, UK,
2 Human Genetics Department, Merck & Co. Inc., West Point, PA, USA,
3 Swiss Federal Institute of Technology, Zurich, Switzerland,
4 Division of Gastroenterology, University Hospital, Nottingham, UK,
5 Università di Chieti `G.D'Annunzio', Cattedra di Farmacologia 1, Chieti, Italy,
6 2nd Department of Medicine, Lainz Hospital, Vienna, Austria,
7 Leiden University Hospital, Department of Rheumatology, Leiden, The Netherlands,
8 St Vincent's Hospital, Darlinghurst, NSW, Australia,
9 Institut de Rheumatologie, Hospital Cochin, Paris, France,
10 Merck & Co. Inc., Rahway, NJ, USA,
11 University Hospital, Madrid, Spain,
12 Oslo City Department of Rheumatology, Diakonhjemmet Hospital, Norway,
13 Department of Rheumatology, University Hospital, Groningen, The Netherlands,
14 Vascular Inflammation, The William Harvey Research Institute, St Bartholomew's & The Royal London School of Medicine and Dentistry, London, UK and
15 Department of Internal Medicine and Rheumatology, Medizinische Hochschule Hanover, Germany
Correspondence to:
P. Brooks, University of Queensland, Edith Cavell Building, Royal Brisbane Hospital, Herston, Qld. 4029, Australia.
The International Consensus Meeting on the Mode of Action of COX-2 Inhibition (ICMMAC) brought together 17 international experts in arthritis, gastroenterology and pharmacology on 5–6 December 1997. The meeting was convened to provide a definition of COX-2 specificity and to consider the clinical relevance of COX-2-specific agents. These compounds are a new class of drugs that specifically inhibit the enzyme COX-2 while having no effect on COX-1 across the whole therapeutic dose range. The objectives of the meeting were to review the currently available data regarding the roles and biology of COX-1 and COX-2, and to foster a consensus definition on COX-2 specificity. At the present time, no guidelines exist for the in vitro and in vivo assessment of COX specificity, and it was felt that consensus discussion might clarify some of these issues. The meeting also reviewed recent clinical data on COX-2-specific inhibitors. The following article reflects discussion at this meeting and provides a consensus definition of COX-2-specific inhibitors.
KEY WORDS: Cyclooxygenase, COX-2-specific inhibition, COX-1, COX-2/COX-1 ratios, Osteoarthritis, Acute pain, NSAIDs, Gastrointestinal safety
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