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(Cox-2 inhibitors) Summary of COX-2 inhibitors are a type of nonsteroidal anti-inflammatory drug (NSAID) that specifically inhibits an enzyme known as cyclooxygenase-2 (COX-2). These drugs are used to treat pain and may be less likely to cause gastrointestinal bleeding than other NSAIDs. Cyclooxygenase comes in two forms: COX-1 and COX-2. Unlike other NSAIDs, COX-2 inhibitors suppress only one form of cyclooxygenase, COX-2. Researchers believe part of the role of COX-1 is to protect your stomach lining. Because the other NSAIDs suppress its function, side effects such as stomach and bleeding problems can result. COX-2 inhibitors affect only that form of the enzyme (COX-2) involved in inflammation. Because they don't affect COX-1, COX-2 inhibitors may cause fewer side effects in your digestive system. However, this result, along with the long-term effects of COX-2 inhibitors, needs to be verified with further research. In addition, COX-2 inhibitors don't thin your blood like aspirin and other NSAIDs. If your doctor has prescribed aspirin for a heart condition, don't use COX-2 inhibitors instead.
Rofecoxib is a nonsteroidal anti-inflammatory drug (NSAID) developed by Merck & Co. to treat osteoarthritis, acute pain conditions, and dysmenorrhoea. Rofecoxib was approved as safe and effective by the Food and Drug Administration (FDA) on May 20, 1999 and was subsequently marketed under the brand name Vioxx, Ceoxx and Ceeoxx. Rofecoxib gained widespread acceptance among physicians treating patients with arthritis and other conditions causing chronic or acute pain. Worldwide, over 80 million people were prescribed rofecoxib at some time. On September 30, 2004, Merck voluntarily withdrew rofecoxib from the market because of concerns about increased risk of heart attack and stroke associated with long-term, high-dosage use. Rofecoxib was one of the most widely used drugs ever to be withdrawn from the market. In the year before withdrawal, Merck had sales revenue of US $2.5 billion from Vioxx. Vioxx was also withdrawn from the market, as was it's successor Prexige on August 14, 2007 due to causing severe liver damage and 2 deaths. Rofecoxib was available on prescription as tablets and as an oral suspension On November 5 the medical journal The Lancet published a meta-analysis of the available studies on the safety of rofecoxib (Jüni et al., 2004). The authors concluded that, owing to the known cardiovascular risk, rofecoxib should have been withdrawn several years earlier. The Lancet published an editorial which condemned both Merck and the FDA for the continued availability of rofecoxib from 2000 until the recall. Merck responded by issuing a rebuttal of the Jüni et al. meta-analysis that noted that Juni omitted several studies that showed no increased cardiovascular risk. (Merck & Co., 2004). In 2005, advisory panels in both the U.S. and Canada encouraged the return of rofecoxib to the market, stating that rofecoxib's benefits outweighed the risks for some patients. The FDA advisory panel voted 17-15 to allow the drug to return to the market despite being found to increase heart risk. The vote in Canada was 12-1, and the Canadian panel noted that the cardiovascular risks from rofecoxib seemed to be no worse than those from ibuprofen -- though the panel recommended that further study was needed for all NSAIDs to fully understand their risk profiles. Notwithstanding these recommendations, Merck has not returned rofecoxib to the market.
Source: Marketdata Enterprises, Inc., Chronic Pain Management Programs: A Market Analysis, Wikipedia, various other sources
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