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  Česky / Czech version Čes. Revmatol., 12, 2004, No. 4, p. 145-156
 
Cardiovascular and renal safety of coxibs 
Forejtová Š., Pavelka K. 

Revmatologický ústav Praha
 


Summary:

       Coxibs have been developed as an alternative of conventional non-steroidal antirheumatic drugs in order to reduce the risk of gastrointestinal complications. The issue of cardiovascular safety of coxib administration has been discussed in connection with the VIGOR study because patients which had been using rofecoxib had increased occurrence of non-fatal heart attack in comparison to naproxen. The outcomes of other studies checking coxib administration safety are controversial. These studies were mostly retrospective population-based and observational, in which negative influence on cardiovascular system could not been proved for sure yet. The mechanism which could be responsible for increased incidence of cardiovascular disorders is not clear. A variation of prostacyclin (PGI2/t) hromboxan (TXA2) proportion is suggested to be due to cyclooxygenase-2 inhibitors administration. Presumably the negative influence on cardiovascular system might differ among different coxib agents. Recently it has been shown that e.g. celecoxib might have cardioprotective effect for its endothelial dysfunction improvement in patients with ischemic heart disease and hypertension. Reviews that assessed renal safety of coxib administration showed that cyclooxygenase-2 inhibitors are not safer than conventional NSAIDs with regard to renal function alteration, natrium retention and development of hypertension.

        Key words: cardiovascular, renal, safety, coxibs, cyclooxygenase, COX-1, COX-2, heart attack, hypertension
       

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