This discussion of preferential COX-2 inhibition focuses on a new treatment approved for symptomatic osteoarthritis.
Meloxicam (Mobic) is the latest cyclo-oxygenase (COX) inhibitor that has become available in Australia which has a preferential inhibitory action on the COX-2 isoform of the enzyme. It is, in fact, a relatively old drug developed prior to the discovery of COX-2 that was subsequently found to have a similar order of selectivity for COX-2 as celecoxib. This post-hoc identification of meloxicam as a COX-2 inhibitor is reflected in its structural classification as an oxicam, not as a coxib.
This article focuses on use of meloxicam, which is available for symptomatic treatment of osteoarthritis as a restricted PBS benefit. In addition, results of recent trials that are shedding more light on the on the toxicity profile of selective COX-2 inhibitors will be discussed briefly.