ReviewThe Journal of clinical investigation2006
Biological basis for the cardiovascular consequences of COX-2 inhibition: therapeutic challenges and opportunities.
Review in The Journal of clinical investigation, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 348 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
348 citing papers in PubMed, 6 syntheses or guidelines pooled it, 1,012 citations in OpenAlex.
- Cardiovascular safety of celecoxib in rheumatoid arthritis and osteoarthritis patients: A systematic review and meta-analysis.PloS one · 2021Pooled it
- Clinical Pharmacogenetics Implementation Consortium Guideline (CPIC) for CYP2C9 and Nonsteroidal Anti-Inflammatory Drugs.Clinical pharmacology and therapeutics · 2020Guideline
- Non-steroidal anti-inflammatory agents to induce regression and prevent the progression of cervical intraepithelial neoplasia.The Cochrane database of systematic reviews · 2018Pooled it
- The effect of COX-2-selective meloxicam on the myocardial, vascular and renal risks: a systematic review.Inflammopharmacology · 2015Pooled it
- Non-steroidal anti-inflammatory agents to induce regression and prevent the progression of cervical intraepithelial neoplasia.The Cochrane database of systematic reviews · 2014Pooled it
- Use of non-steroidal anti-inflammatory drugs that elevate cardiovascular risk: an examination of sales and essential medicines lists in low-, middle-, and high-income countries.PLoS medicine · 2013Pooled it
- Degree of Cyclooxygenase-2 Inhibition Modulates Blood Pressure Response.Hypertension (Dallas, Tex. : 1979) · 2026Trial
- Efficacy of preoperative ibuprofen and meloxicam on the success rate of inferior alveolar nerve block for teeth with irreversible pulpitis.International dental journal · 2017Trial
- Cyclooxygenases 1 and 2 differentially regulate blood pressure and cerebrovascular responses to acute and chronic intermittent hypoxia: implications for sleep apnea.Journal of the American Heart Association · 2014Trial
- Effect of zileuton and celecoxib on urinary LTE4 and PGE-M levels in smokers.Cancer prevention research (Philadelphia, Pa.) · 2013Trial
- Clinical Pharmacokinetics and Disposition of Imrecoxib.Clinical pharmacokinetics · 2026Review
- Design, synthesis, molecular docking and molecular dynamics simulations of pyrazolo[3,4-RSC advances · 2026Article
- Beyond Carrier Design: Fabrication Method as the Hidden Driver of NSAID Nanomedicine Performance.Pharmaceutics · 2026Review
- Platelet activation, aspirin, and cancer: From basic science to clinical trials.Pharmacological reviews · 2026Review
- The future of brain tumor treatment: integrating platelet-based liquid biopsy, advanced drug delivery systems, and eicosanoid inhibition.Frontiers in pharmacology · 2026Review
- Design and Synthesis of Novel Spiropyridine Derivatives as Promising Anti-inflammatory and Gene-targeting Agents Against COVID-19.Current pharmaceutical design · 2026Article
- The crucial role of thromboxane AFrontiers in pharmacology · 2026Review
- Eosinophil-derived COX-2 protects against experimental colitis through the PGEbioRxiv : the preprint server for biology · 2025Article
- Exploiting the 2-(1,3,4,9-tetrahydropyrano[3,4-Journal of medicinal chemistry · 2025Article
- Reprogramming inflammation: Mechanisms and therapeutic targeting of eicosanoids and pro-resolving mediators.European journal of pharmacology · 2025Review
288 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
Inhibitors selective for prostaglandin G/H synthase-2 (PGHS-2) (known colloquially as COX-2) were designed to minimize gastrointestinal complications of traditional NSAIDs--adverse effects attributed to suppression of COX-1-derived PGE2 and prostacyclin (PGI2). Evidence from 2 randomized controlled-outcome trials (RCTs) of 2 structurally distinct selective inhibitors of COX-2 supports this hypothesis. However, 5 RCTs of 3 structurally distinct inhibitors also indicate that such compounds elevate the risk of myocardial infarction and stroke. The clinical information is biologically plausible, as it is compatible with evidence that inhibition of COX-2-derived PGI2 removes a protective constraint on thrombogenesis, hypertension, and atherogenesis in vivo. However, the concept of simply tipping a "balance" between COX-2-derived PGI2 and COX-1-derived platelet thromboxane is misplaced. Among the questions that remain to be addressed are the following: (a) whether this hazard extends to all or some of the traditional NSAIDs; (b) whether adjuvant therapies, such as low-dose aspirin, will mitigate the hazard and if so, at what cost; (c) whether COX-2 inhibitors result in cardiovascular risk transformation during chronic dosing; and (d) how we might identify individuals most likely to benefit or suffer from such drugs in the future.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.