[Analgesic effects of cyclooxygenase 2 inhibitors]

Abstract

Traditional pain management strategies for cancer pain have relied on the use of opioids, nonsteroidal anti-inflammatory drugs (NSAIDs) and other adjuvant analgesics. However, the substantial adverse effects associated with their use has left many patients without dependable options for effective treatment. Recent advances in the understanding of pain and its pathophysiologic mechanisms have led to the development of novel therapeutics. Cyclooxygenase(Cox)-2-specific inhibitors (coxib) have an established efficacy in the treatment of chronic and acute pain comparable to that of traditional NSAIDs without the degree of gastrointestinal complication or the platelets inhibitor effect of traditional NSAIDs. Numerous studies have shown that coxibs are efficacious in the management of chronic and acute pain in various clinical settings including postoperative pain. The superior safety profile of coxibs in conjunction with a comparable efficacy to nonselective NSAIDs supports the use of coxibs in balanced analgesic regimens and provides the potential to incorporate coxibs into the pain management algorithm used to treat cancer pain.