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Oral presentation

The largest group of analgesic drugs are the so-called cyclooxygenase inhibitors. This group can be subdivided into four different sub-categories: the so-called acidic cyclooxygenase inhibitors and the non-acidic ones which can both be subdivided into selective and non-selective inhibitors. The acidic compounds are known to be more effective against inflammation but also to cause more serious side effects in the GI-tract. On the other hand the non-acidic compounds are of marginal anti-inflammatory effectiveness but show measurable analgesic effects. They do not damage the GI-tract. Recently these four groups have gained important additions by the discovery and introduction to the market of the so-called selective cyclooxygenase-2-inhibitors. Two non-acidic ones are in broad use worldwide, acidic and selective inhibitors are under clinical investigation. The final decision about their usefulness in man will have to come from clinical trials. The most important recent trials assessing the safety and effectiveness of the new compounds will be presented and discussed, in particular the question: to what extent do pharmacokinetics contribute to effectiveness and clinical toxicity?

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