Nonsteroidal anti-inflammatory drugs, which inhibit both COX-1 and COX-2, are widely used and are effective in treating inflammation and pain, both acute and chronic. The introduction of agents that specifically block COX-2 and not COX-1 was primarily an attempt to decrease the adverse effects that are typically associated with inhibition of COX-1. However, the development of COX-2–specific inhibitors has raised the issue of the potential role, if any, of COX-1–derived prostaglandins in inflammation and pain. In his letter, Dr Bannwarth specifically questions whether conventional NSAIDs and COX-2–specific inhibitors may differ with respect to their analgesic properties.
Lipsky PE. Are COX-2 Inhibitors as Effective as Conventional NSAIDs in Acute Pain States?—Reply. Arch Intern Med. 2001;161(1):127-128. doi: