Cardiovascular and renal safety of coxibs

Overview

Coxibs have been developed as an alternative of conventional non-steroidal antirheumatic drugs inorder to reduce the risk of gastrointestinal complications. The issue of cardiovascular safety of coxibadministration has been discussed in connection with the VIGOR study because patients which hadbeen 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 studieswere mostly retrospective population-based and observational, in which negative influence oncardiovascular system could not been proved for sure yet. The mechanism which could be responsiblefor 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 differentcoxib agents. Recently it has been shown that e.g. celecoxib might have cardioprotective effectfor its endothelial dysfunction improvement in patients with ischemic heart disease and hypertension.Reviews that assessed renal safety of coxib administration showed that cyclooxygenase-2inhibitors are not safer than conventional NSAIDs with regard to renal function alteration, natriumretention and development of hypertension.

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