BACKGROUND Differences between gastrointestinal and cardiovascular effects of traditional NSAID or cyclooxygenase-2 selective inhibitor (coxib) are affected by drug, dose, duration, outcome definition, and patient gastrointestinal and cardiovascular risk factors. We calculated the absolute risk for each effect. METHODS We sought studies with large amounts of information to calculate annualise...

Colorectal cancer (CRC) is presently one of the most common causes of cancer-related death in our setting and affects a great number of people each year. Screening strategies are commonly used but they do not seem enough to avoid CRC development or prevent completely its mortality. Because of this fact other prevention strategies have gained interest in recent years. Chemoprevention seems to be...

PHYSICIANS, PATIENTS, AND THE GENERAL PUBLIC ARE confronted with an acute confusional state regarding the cardiovascular safety of medicines for arthritis. Since September 30, 2004, the day that rofecoxib was precipitously withdrawn, there has hardly been a day without significant news on the general topic of cyclooxygenase 2 (COX-2) inhibitors. On December 9, 2004, the US Food and Drug Adminis...

It is well established that the use of traditional nonsteroidal anti-inflammatory drugs (NSAIDs) increase the vulnerability of the gastrointestinal (GI) mucosa for the development of peptic lesions and serious ulcer complications. In addition, selective and traditional NSAIDs have also been associated with increased frequency of cardiovascular toxicity, especially in susceptible patients. The o...

Cyclooxygenase (COX), also known as prostaglandin endoperoxide synthase, is the key enzyme required for the conversion of arachidonic acid to prostaglandins. Two COX isoforms have been identifi ed, COX-1 and COX-2. Generally, the COX-1 enzyme is produced constitutively (e.g. in gastric mucosa), whereas COX-2 is highly inducible (e.g. at sites of infl ammation and cancer). Traditional non-steroi...

Nonsteroidal antiinfl ammatory drugs (NSAIDs) are the most widely used class of therapeutic agents for the treatment of a variety of acute and chronic rheumatic conditions to provide analgesia and supress infl ammation. Most treatment is short-term management for the relief of signs and symptoms in osteoarthritis, but NSAIDs are widely used too in the long-term treatment of patients with rheuma...

Prostaglandins and leukotrienes are potent eicosanoid lipid mediators derived from phospholipase-released arachidonic acid that are involved in numerous homeostatic biological functions and inflammation. They are generated by cyclooxygenase isozymes and 5-lipoxygenase, respectively, and their biosynthesis and actions are blocked by clinically relevant nonsteroidal anti-inflammatory drugs, the n...