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Journal of Clinical and Experimental Toxicology | Volume: 2
December 03-04, 2018 | Dubai, UAE
International Conference on
6th International Conference on
Toxicology, Clinical Toxicology & Pharmacology
Recycling & Waste Management
Joint Event
&
Abating the aches with NSAIDs: Aching matters for the heart
Kiran Dubey
Jamia Hamdard University, India
The potential adverse cardiovascular events reported with
selective COX-2 inhibitors (coxibs) led to the withdrawal of
most blockbuster molecules viz. rofecoxib and valdecoxib from
the market. Etoricoxib and nimesulide were never approved
in many countries. The US FDA had decided, however that
celecoxib should remain in the market after concluding that the
benefits of celecoxib outweigh the potential risks. An increased
risk of myocardial infarction has also been associated with the
use of non-selective non-steroidal anti-inflammatory drugs
(ns NSAIDs) such as diclofenac sodium and naproxen in some
observational clinical and experimental studies. Subsequently,
the FDA labeled all COX-2 selective and ns NSAIDs as increasing
the cardiovascular risk and raised an alert for practitioners
while treating patients with the established ischemic disease.
The cardiovascular risk appears to be a class effect of coxibs
and adverse events were also reported with celecoxib, leaving
physicians in a dilemma for treating arthritic population at
underlying risk of cardiovascular disease. The strategies to
mitigate the cardiovascular events appear to use the low doses
of coxibs for short duration or concurrent administration of
aspirin. However, most patients with arthritis require chronic
therapy and it is unclear whether aspirin mitigates or abolishes
NSAIDs-related risk. Alternate approaches may be to use nitric
oxide donor NO-NSAIDs, dual COX/LOX inhibitors or anti-
TNF therapy. Despite the unprecedented advances in drug
discovery, it remains a major challenge for the pharma industry
to discover aching remedies that don’t ache the heart as well.
Speaker Biography
Kiran Dubey is currently associated with Jamia Hamdard as a Senior Assistant Professor
in the Department of Pharmacology, School of Pharmaceutical Education and Research,
New Delhi. She has also served in the Medical Information Department of Ranbaxy
Laboratories, Systopic Laboratories, Dee Pharma Ltd and Skin Institute and School of
Dermatology. Her areas of research include cardiovascular safety profile of NSAIDs,
diabetes and related complications. She has guided twenty-six post graduate students
and three Ph.D. students in the field of Pharmacology and Pharmacy Practice, published
articles and has been reviewer for International and National journals of repute.
e:
Kiran Dubey , Toxicology 2018 & Recycling 2018, Volume 2
DOI: 10.4066/2630-4570-C1-003