Valdecoxib综述。

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查维斯ML，德科特CJ

Valdecoxib综述。

中华临床杂志2003年3月25日(3):817-51。

PubMed ID

12852704 (PubMed视图

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摘要

背景:传统的非甾体抗炎药(NSAIDs)，如双氯芬酸、布洛芬、萘普生和相关药物是环氧化酶-1 (COX-1)和COX-2的非选择性抑制剂，它们催化前列腺素合成。这种抑制不仅解释了这些药物的镇痛、抗炎和退热作用，而且还解释了诸如胃粘膜损伤和肾毒性等副作用。大量证据表明，保留COX-1有利于胃安全。目的:本文综述了关于新型cox -2选择性抑制剂valdecoxib的现有信息，包括其临床药理学、药代动力学、不良反应、潜在的药物相互作用、禁忌症和警告。综述了临床试验的疗效和耐受性。方法:通过检索PubMed和MEDLINE(1966- 2002年12月)和国际药学文摘(1970- 2002年12月)确定纳入本综述的文章。必威国际app必威国际app搜索词包括valdecoxib, Bextra, cox -2选择性抑制剂，coxibs和选择性环加氧酶抑制剂。对已确定的文章的参考书目进行了审查，以寻找其他出版物。还从valdecoxib的制造商获得了产品信息。结果:共开展14项临床研究，涉及> 4000例患者。 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.

引用本文的药物库数据

药物靶点

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