Selective inhibitors of cyclooxygenase-2: a growing class of anti-inflammatory drugs.

For about two years, selective inhibitors of cyclooxygenase-2 have been hailed as powerful additions to the armamentarium of nonsteroidal anti-inflammatory drugs (NSAIDs). Predicted by financial analysts to become among the pharmaceutical industry's greatest-ever blockbusters, two so-called coxibs are now widely utilized clinically: rofecoxib (Vioxx, Merck) and celecoxib (Celebrex, Monsanto). The clinical advantages of the coxibs over traditional NSAIDs are related to the distinct roles played by cyclooxygenase-2 in comparison to its earlier described isoform, cyclooxygenase-1. Ongoing research into the disparate roles of the two isoforms will have implications not only for the pharmaceutical use of coxibs, but also for our basic appreciation of inflammation, cardiovascular diseases, Alzheimer's disease, cancer, and more.