By: Sara M. Aksoy
Cox-2 inhibitors, the new group of NSAIDs (non-steroidal anti-inflammatory drugs) on the market, have created quite a stir in the arthritis community. Often referred to as “COX-2s,” these drugs include the popular Rofecoxib (Vioxx), Celecoxib (Celebrex), and Valecoxib (Bextra).
So what is so special about the new COX-2s? To understand the unique properties of these drugs, it is important to know those of other NSAIDs.
NSAIDs, the most commonly used medications by arthritis patients, are helpful in reducing the pain and swelling associated with arthritis. This class includes drugs such as aspirin, ibuprofen, and naproxen, among others. NSAIDs take action by blocking the production of prostaglandins, a class of chemicals in the body that includes substances that contribute to pain. NSAIDs block the enzymes responsible for the production of prostaglandins, specifically the COX-1 and COX-2 enzymes. While the COX-2 enzyme makes the pain-causing prostaglandins, the COX-1 enzyme is responsible for creating prostaglandins that, among other things, protect the lining of the digestive system from its otherwise harmful acids. Unfortunately, traditional NSAIDs cannot differentiate between the COX-1 and COX-2 enzymes, and therefore block the action of each. For this reason, many people taking the traditional NSAIDS experience stomach irritation and ulcers.
COX-2s, on the other hand, can identify the COX-2 enzyme from its COX-1 counterpart. For this reason, the COX-2s are not as likely to be associated with the side-effects characteristic of traditional NSAIDs, and studies show that they result in a lower incidence of stomach irritation and ulcers.
While COX-2s provide added protection against stomach ulcers and bleeding, they do not afford what some consider to be a beneficial side-effect of traditional NSAIDs, the thinning of the blood. For this reason, when switching from traditional NSAIDs to COX-2s, some at-risk patients start taking baby aspirin or another blood thinner for protection against heart attack and stroke. Speak with your doctor about this combination.