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COX-2 and liaments

Posted by Scott R on 12/25/01 at 16:55 (067791)

From the current issue of JAMA:
(whatever is preventing healing in ligaments is likely also happening in the fascia.)

COX-2 Inhibitors and Ligaments

Mike Mitka

Cyclooxygenase 2-specific (COX-2) inhibitors, widely prescribed for arthritis symptoms, may impair ligament healing associated with sprains, report researchers at the University of North Carolina at Chapel Hill School of Medicine. Unlike earlier generations of nonsteroidal anti-inflammatory drugs, which have been found to promote ligament healing, the COX-2 inhibitors apparently do not, said Lawrence E. Dahners, MD, professor of orthopedics.

The study in rats involved an experimental model for an acute injury of the medial collateral ligament, in humans the most common site of knee sprains. Postoperatively, half the animals were given the COX-2 inhibitor celecoxib for the first 6 days of recovery and half were not treated. About 2 weeks later, the injured and uninjured ligaments were tested for healing strength. Celecoxib decreased ligament healing strength by 32%, the researchers said.

They cautioned that the findings are preliminary and call for further study to determine the long-term effects on ligament healing of COX-2 inhibitors. The findings appear in the November 14 issue of the American Journal of Sports Medicine.

Re: COX-2 and liaments

rebecca h on 12/25/01 at 23:51 (067798)

Scott,

Is Viox a COX-2 inhibitor? That is what I'm taking for pain.

rebecca

Re: COX-2 and liaments

D.Thomas on 12/26/01 at 09:34 (067808)

Interesting. Vioxx and Celebrex are COX-2 inhibitor.

Re: COX-2 and liaments

rebecca h on 12/26/01 at 10:56 (067814)

What about ibuprofen? is it also COX-2 inhibitor

Re: COX-2 and liaments

D.Thomas on 12/26/01 at 14:18 (067826)

No

Re: How about Naproxin? Does anyone know?

Suzanne D on 12/26/01 at 17:27 (067845)

Does anyone know if Naproxin is also a Cox-2 inhibitor?

Re: How about Naproxin? Does anyone know?

wendyn on 12/26/01 at 20:29 (067855)

I don't think so - I think Naproxen is a first generation NSAID - different than Celebrex or Vioxx. But I'm not a doctor.

Re: How about Naproxin? Does anyone know?

PatC on 12/27/01 at 07:28 (067878)

Wendyn is right. Naproxin,sometimes sold as Aleve, is not.

Re: How about Naproxin? Does anyone know?

D.Thomas on 12/27/01 at 11:02 (067890)

As far as I have heard, Vioxx and Celebrex are the only anti-inflam that are cox-2 inhibitors on the market. I have heard of a couple more waiting to be approved by the Gov't. But I am not doctor.

Re: How about Naproxin? Does anyone know?

Suzanne D on 12/27/01 at 15:28 (067909)

Thank you for your answers! I did not realize that Naproxin was the same drug as Alleve!

Re: How about Naproxin? Does anyone know?

john h on 12/27/01 at 15:29 (067911)

D. Thomas there are more Cox-2 inhibitors coming. I was watching a program about one that the FDA is about to approve.

Re: COX-2 and liaments

Ed Davis, DPM on 1/03/02 at 22:15 (068622)

Intersting. We know that it actually takes a certain amount of inflammation to activate the healing process. Not all inflammation is bad--it is a natural phenomenon. ESWT creates a certain amount of inlammation to get the healing process going.
Ed

Re: COX-2, COX-1 -clarifications

Ed Davis, DPM on 1/03/02 at 22:21 (068623)

The older drugs inhibited both COX-1 and Cox-2. The big difference is that the newer drugs, Celebrex and Vioxx are SELECTIVE COX-2 inhibitors, that is, they leave COX-1 alone. COX-2 is more specifically aimed at inflammation so COX-2 selective inhibitors treat inflammation without affecting gastointestinal function or effecting blood clotting like the ones that inhibit COX-1 (the COX-2 inhibitors are not perfect so there still is some small gastrointestinal effect).
Ed

Re: COX-2 and liaments

john h on 1/04/02 at 10:46 (068674)

How right you are Dr. Davis! I have often read than inflamation, swelling is the bodys way of protecting an injured area.

Re: COX-2 and liaments

rebecca h on 12/25/01 at 23:51 (067798)

Scott,

Is Viox a COX-2 inhibitor? That is what I'm taking for pain.

rebecca

Re: COX-2 and liaments

D.Thomas on 12/26/01 at 09:34 (067808)

Interesting. Vioxx and Celebrex are COX-2 inhibitor.

Re: COX-2 and liaments

rebecca h on 12/26/01 at 10:56 (067814)

What about ibuprofen? is it also COX-2 inhibitor

Re: COX-2 and liaments

D.Thomas on 12/26/01 at 14:18 (067826)

No

Re: How about Naproxin? Does anyone know?

Suzanne D on 12/26/01 at 17:27 (067845)

Does anyone know if Naproxin is also a Cox-2 inhibitor?

Re: How about Naproxin? Does anyone know?

wendyn on 12/26/01 at 20:29 (067855)

I don't think so - I think Naproxen is a first generation NSAID - different than Celebrex or Vioxx. But I'm not a doctor.

Re: How about Naproxin? Does anyone know?

PatC on 12/27/01 at 07:28 (067878)

Wendyn is right. Naproxin,sometimes sold as Aleve, is not.

Re: How about Naproxin? Does anyone know?

D.Thomas on 12/27/01 at 11:02 (067890)

As far as I have heard, Vioxx and Celebrex are the only anti-inflam that are cox-2 inhibitors on the market. I have heard of a couple more waiting to be approved by the Gov't. But I am not doctor.

Re: How about Naproxin? Does anyone know?

Suzanne D on 12/27/01 at 15:28 (067909)

Thank you for your answers! I did not realize that Naproxin was the same drug as Alleve!

Re: How about Naproxin? Does anyone know?

john h on 12/27/01 at 15:29 (067911)

D. Thomas there are more Cox-2 inhibitors coming. I was watching a program about one that the FDA is about to approve.

Re: COX-2 and liaments

Ed Davis, DPM on 1/03/02 at 22:15 (068622)

Intersting. We know that it actually takes a certain amount of inflammation to activate the healing process. Not all inflammation is bad--it is a natural phenomenon. ESWT creates a certain amount of inlammation to get the healing process going.
Ed

Re: COX-2, COX-1 -clarifications

Ed Davis, DPM on 1/03/02 at 22:21 (068623)

The older drugs inhibited both COX-1 and Cox-2. The big difference is that the newer drugs, Celebrex and Vioxx are SELECTIVE COX-2 inhibitors, that is, they leave COX-1 alone. COX-2 is more specifically aimed at inflammation so COX-2 selective inhibitors treat inflammation without affecting gastointestinal function or effecting blood clotting like the ones that inhibit COX-1 (the COX-2 inhibitors are not perfect so there still is some small gastrointestinal effect).
Ed

Re: COX-2 and liaments

john h on 1/04/02 at 10:46 (068674)

How right you are Dr. Davis! I have often read than inflamation, swelling is the bodys way of protecting an injured area.