Role of the Selective Cyclo-oxygenase-2 (cox-2) Inhibitors in Children

Correspondence to: Mr Sean Turner, Clinical Services, Princess Margaret Hospital, Roberts Road, Perth, Western Australia 6008, Australia; sean.turner@health. wa.gov.au _________________________ T here has been a great deal written about the use of selective cyclo-oxygenase-2 (COX-2) inhibitors in the adult population. Yet despite this there is still controversy over their place in treatment and in the interpretation of evidence from the major clinical trials. In the UK the National Institute for Clinical Excellence (NICE) recommended COX-2 inhibitors only be prescribed for osteoarthritis and rheumatoid arthritis patients at high risk of developing serious gastrointestinal adverse effects. Their role in children is even less well defined, with only a small number of published studies. Yet despite this lack of published evidence there is an undercurrent among paediatric practitioners to prescribe these agents. The aim of this review is to highlight the current published literature on the use of COX-2 inhibitors in children.