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Is the use of COX-2 inhibitors in gastroenterology cost-effective?

Nature Clinical Practice Gastroenterology & Hepatology volume 1, pages 60–61 (2004)Cite this article

Non-steroidal anti-inflammatory drugs (NSAIDs) are prized for their ability to provide simple and effective relief from pain and reduce inflammation. Recent data have suggested that NSAIDs might also prevent various cancers (e.g. gastrointestinal, breast and lung) and delay the onset of Alzheimer's disease, which indicates that their use might increase.1 These benefits come with costs in terms of adverse effects on the gastrointestinal tract, blood pressure and renal function. NSAIDs are a major cause of the endemic of ulcer complications, with as many as 103,000 hospitalizations and over 7,000 deaths a year attributable to NSAID use in the US.2

Selective and non-selective NSAIDs have a similar efficacy in terms of producing analgesia and anti-inflammatory activity, as well as similar rates of adverse effects on blood pressure and renal function. Therefore, any differences in cost-benefits must accrue from differences in adverse events in the gastrointestinal tract. The gastrointestinal complications of NSAIDs have been attributed to their ability to inhibit COX-1. Hence, the introduction of selective COX-2 inhibitors suggested that the benefits of NSAIDs could be achieved without gastrointestinal toxicity.

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Authors and Affiliations

  1. Professor of Medicine & Molecular Virology and Microbiology, Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX, USA

    David Y Graham

  2. Reader in Medicine, Department of Medicine & Therapeutics, The Chinese University of Hong Kong, SAR, PRC

    Francis KL Chan

Authors
  1. David Y Graham
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  2. Francis KL Chan
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Correspondence to David Y Graham.

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Graham, D., Chan, F. Is the use of COX-2 inhibitors in gastroenterology cost-effective?. Nat Rev Gastroenterol Hepatol 1, 60–61 (2004). https://doi.org/10.1038/ncpgasthep0043

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