The Comparative Contribution of COX-I Vs COX-II In the Pathogenesis of Osteoarthritis

Osteoarthritis is an inflammatory joint disease that affects millions worldwide. Research indicates that both the COX-1 and COX-2 enzymatic pathways are implicated in the pathogenesis, but few studies have compared the relative contribution of each pathway. A systematic review of a study that assessed the osteoarthritis disease severity change using the visual analog scale (VAS) for those with osteoarthritis using a COX-1 selective S-flurbiprofen plaster therapy for knee osteoarthritis was compared to the findings of another study which assessed the osteoarthritis disease severity change for those taking a COX-2 selective celecoxib oral therapy. The COX-1 selective S-flurbiprofen plaster therapy had statistically significant reductions in VAS scores as compared to the conventional treatment by the end of the study. Additionally, those taking the COX-2 selective celecoxib oral therapy also showed statistically significant decreases in VAS scores as compared to conventional NSAIDs. When average VAS score reductions between those taking the COX-1 selective S-flurbiprofen plaster treatments were compared to that of those taking the COX-2 selective celecoxib oral therapy, those taking the S-flurbiprofen plaster treatments had a greater reduction in pain severity than did those taking the celecoxib. Further studies with greater sample sizes and different routes of administration are necessary to assess which enzymatic pathway is more implicated in the pathogenesis of osteoarthritis.