Valdecoxib:审查。

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查韦斯ML, DeKorte CJ

Valdecoxib:审查。

其他。2003年3月,25 (3):817 - 51。

PubMed ID

12852704 (在PubMed

]

文摘

背景:传统的非甾体类抗炎药(非甾体抗炎药),如双氯芬酸、布洛芬、萘普生,及相关代理的非选择性抑制剂cyclooxygenase-1 (COX-1)和cox - 2,促进前列腺素合成。这不仅抑制账户镇痛,抗炎,这些代理和退热的效果,而且对胃粘膜损伤和肾毒性等副作用。大量证据表明,爱惜COX-1便于胃安全。目的:本文综述新COX-2-selective抑制剂valdecoxib可用的信息,包括它的临床药理学,药物动力学,不利影响,潜在的药物相互作用,和禁忌症和警告。临床试验的结果的有效性和耐受性进行了总结。方法:确定包含综述文章通过搜索PubMed和MEDLINE(1966 - 2002年12月)和国际制药抽象(1970 - 2002年12月)。搜索条件包括valdecoxib、伐地考昔,COX-2-selective抑制剂,coxibs和选择性环氧合酶抑制剂。综述了确定文章的参考书目中额外的出版物。产品信息也从valdecoxib制造商获得。结果:14涉及> 4000名患者进行了临床研究。 Valdecoxib was significantly more effective than placebo in the treatment of adult rheumatoid arthritis, osteoarthritis, pain associated with primary dysmenorrhea, and postoperative pain. Valdecoxib was comparable to naproxen for the treatment of rheumatoid arthritis in 1 study and equivalent to naproxen for the treatment of osteoarthritis in other studies. Three studies found valdecoxib comparable to naproxen sodium for the relief of moderate to severe pain due to primary dysmenorrhea, and others found valdecoxib comparable to oxycodone plus acetaminophen and significantly more effective than rofecoxib for the relief of pain associated with dental surgery (P < 0.05). Four safety studies and 2 reviews of clinical trials documented lower rates of endoscopic gastroduodenal ulcer formation with valdecoxib compared with ibuprofen, naproxen, and diclofenac (P < 0.001 to P < 0.05). Valdecoxib did not inhibit platelet function (bleeding time and platelet aggregation) in healthy adults or in the elderly. Due to the risk of potentially serious skin and allergic reactions, patients who are allergic to sulfa-containing drugs should not take valdecoxib. The drug should be discontinued immediately if rash develops. CONCLUSIONS: In clinical trials, valdecoxib was effective for the treatment of osteoarthritis, rheumatoid arthritis, and moderate to severe pain associated with primary dysmenorrhea. As with the other COX-2-selective inhibitors (celecoxib and rofecoxib), valdecoxib appears to produce less gastrointestinal toxicity than conventional nonselective NSAIDs, although some of the relevant clinical studies have been published only as abstracts. Use of valdecoxib should be reserved for patients at risk for NSAID-induced gastrointestinal problems.

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药物靶点

药物	目标	类	生物	药理作用	行动
双氯芬酸	前列腺素合成酶1 G / H	蛋白质	人类	是的	抑制剂	细节
双氯芬酸	前列腺素合成酶2 G / H	蛋白质	人类	是的	抑制剂	细节
布洛芬	前列腺素合成酶1 G / H	蛋白质	人类	是的	抑制剂	细节
布洛芬	前列腺素合成酶2 G / H	蛋白质	人类	是的	抑制剂	细节