Interní Med. 2001; 3(5): 221-226

COX-2 specifická nesteroidní antirevmatika z pohledu revmatologa a gastroenterologa

MUDr. Zdeněk Dvořák Ph.D2, MUDr. Marcela Kopáčová1, doc. MUDr. Jan Bureš CSc2
1 II. interní klinika LF UK a Fakultní nemocnice, Hradec Králové
2 Revmatologická ordinace, Poliklinika, Masarykovo náměstí, Pardubice

Keywords: celecoxib, rofecoxib, osteoarthritis, rheumatoid arthritis, gastropathy, enteropathy.

Published: December 31, 2001  Show citation

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Dvořák Z, Kopáčová M, Bureš J. COX-2 specifická nesteroidní antirevmatika z pohledu revmatologa a gastroenterologa. Interní Med. 2001;3(5):221-226.

Mnoho milionů lidí užívá denně různá nesteroidní antirevmatika (NSA) a řadí tím tuto lékovou skupinu mezi jednu z nejvíce předepisovaných na světě. Centrum pro kontrolu nemocí v americké Atlantě předpovídá, že stárnutím populace se objeví signifikantní nárůst prevalence degenerativních a zánětlivých revmatických onemocnění, který povede k dalšímu vzestupu spotřeby NSA. V posledních letech 20. století byla vyvinuta nová třída NSA - specifické inhibitory cyklooxygenázy-2 (COX-2), tzv. COX-2 specifická NSA, která mají obdobný analgetický a protizánětlivý efekt jako klasická COX neselektivní NSA, avšak mají výrazně nižší toxicitu na gastrointestinální trakt (GIT). V USA již jsou v běžné klinické praxi užívány dvě COX-2 specifická NSA: celecoxib (Celebrex-) a rofecoxib (Vioxx-); Celecoxib je podáván ke zmírnění projevů a symptomů osteoartrózy (OA) a revmatoidní artritidy (RA) dospělých a v léčbě familiární adenomatózní polypózy (FAP). Rofecoxib je podáván ke zmírnění projevů a symptomů OA, v léčbě akutní bolesti dospělých a primární dysmenorhey. Existují data, že COX-2 specifické inhibitory by mohly být účinné v prevenci kolorektálního karcinomu. Celecoxib i rofecoxib byly v roce 2000 registrovány také v České Republice (ČR); celecoxib pro léčbu osteoartrózy a revmatoidní artritidy, rofecoxib pro léčbu osteoartrózy.

COX-2 Specific Nonsteroidal Anti-Inflammatory Drugs from point of view of an rheumatologist and gastroenterologist

Many millions of people use various of nonsteriodal anti-inflammatory drugs (NSAIDs) on daily basis, thus range this group of drugs among one of the most prescribed ones in the world. Center for Disease Control in Atlanta, U.S.A. estimates that there will be a significant increase in prevalence of degenerative and inflammatory rheumatic diseases caused by aging of population, which will prompt further growth in NSAIDs consumption. In recent years of 20th century new class of NSAIDs has been developed - specific inhibitors of cyclooxygenase-2 (COX 2), so called COX-2 specific NSAIDs. They exhibit similar analgesic and anti-inflammatory effect like classical COX nonselective NSAIDs, but they show significantly lower toxicity on GI tract. In the USA two of COX-2 specific NSAIDs are now being widely used in clinical practice, they are: celecoxib (Celebrex-) and rofecoxib (Vioxx-). Celecoxib is used to diminish signs and symptoms of osteoarthritis (OA) and rheumatoid arthritis (RA) of adults and in treatment of familial adenomatous polyposis (FAP). Rofecoxib is used to diminish signs and symptoms of OA, in treatment of acute pain in adults and in primary dysmenorrhea. Data suggest that COX-2 specific inhibitors could be efficient in colon cancer prevention. Celecoxib and rofecoxib have been registered in 2000 in Czech republic, celecoxib for treatment of osteoarthritis and rheumatoid arthritis, rofecoxib for treatment of osteoarthritis.

Revmatologická ordinace, Poliklinika, Masarykovo náměstí, Pardubice,

II. interní klinika LF UK a Fakultní nemocnice, Hradec Králové

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