Sunday 19 December 2021

Determination of Gastrointestinal Toxicity of Selective COX-2 Inhibitors in Comparison with Conventional NSAIDs | Chapter 12 | Current Aspects in Pharmaceutical Research and Development Vol. 6

 Background: The most prevalent side effects of NSAIDs are adverse gastrointestinal events, which are thought to be caused by the suppression of gastric COX-1, which is responsible for the manufacture of prostaglandins that typically regulate acid secretion and protect the mucosa. According to previous research, selective COX-2 inhibitors are safer than non-selective cyclooxygenase inhibitors when it comes to gastrointestinal side effects. However, current research shows that the gastrointestinal safety of these selective COX-2 inhibitors is comparable to that of traditional NSAIDs.

Aims: Given the increased use of selective COX-2 inhibitors, the goal of this study is to determine if selective COX-2 inhibitors offer any advantages over traditional NSAIDs in terms of gastrointestinal adverse effects.

Patients were separated into eight groups, each with fifteen patients. For 15 days, each group was given one of the eight NSAIDs that had been chosen for the study. Along with the symptomatic assessment of stomach toxicity, both pre and post-treatment Hb percent values are determined, tabulated, and statistically analysed in the selected group.

On symptomatic assessment, both diclofenac and meloxicam showed significant changes in Hb percent values ('p' value 0.02 each), although selective COX-2 inhibitors like nimesulide and celecoxib showed no less stomach toxicity than diclofenac. Diclofenac and meloxicam showed a significant shift in the 'p' value in the assessment of Hb percent change both before and after therapy, indicating that gastric bleeding erosions must have caused such alterations and therefore anaemia, despite the absence of any warning symptoms.

Conclusions: When it came to gastrointestinal toxicity, selective COX-2 inhibitors had no advantage over non-selective NSAIDs in our short-term trial.

Author(S) Details

K. Hima Bindu
Department of Pharmacology, Kakatiya Medical College, Warangal-506007, Telangana, India.

G. Venkat Rao
Department of Orthopaedics, Kakatiya Medical College, Warangal-506007, Telangana, India.

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