The Journal of Bone and Joint Surgery (American). 2005;87:245-246.
doi:10.2106/JBJS.D.02855
© 2005 The Journal of Bone and Joint Surgery, Inc.
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 Pain Management Test 2: Spring 2005
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Editorial

Cardiovascular Risks of Coxibs: The Orthopaedic Perspective

Timothy Bhattacharyya, MD1 and R. Malcolm Smith, MD2

1 Massachusetts General Hospital
Brigham and Women's Hospital
Boston, Massachusetts
2 Massachusetts General Hospital
Boston, Massachusetts

The first 150 words of the full text of this article appear below.

On September 30, 2004, Merck & Co. (Whitehouse Station, New Jersey) withdrew its blockbuster drug rofecoxib from the worldwide market. After just five years on the market, the annual sales of rofecoxib (Vioxx) had grown to $2.5 billion. Rofecoxib and celecoxib (Celebrex; Pfizer, New York, NY) belong to a relatively new class of nonsteroidal anti-inflammatory drugs that were designed to selectively inhibit the COX-2 (cyclooxygenase-2) enzyme and thus reduce gastrointestinal side effects. While the coxibs have been proven to be effective for reducing arthritis symptoms, their safety has been controversial. This review updates orthopaedic surgeons on the present status of the coxib controversy.

The COX-1 enzyme metabolizes arachidonic acid to prostaglandins. The COX-1 enzyme is constitutively expressed in most tissues, including the gastric mucosa, whereas expression of COX-2 is thought to be induced in response to inflammation. Thus, COX-2-selective inhibitors were designed to produce the analgesic effects of nonsteroidal . . . [Full Text of this Article]


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