COX-inhibiting nitric oxide donators are being developed to mitigate the blood pressure increases and cardiovascular risks associated with traditional NSAIDs in patients with osteoarthritis.
Potential NSAID risk mitigation in osteoarthritis remains unproven; leaves open need for dedicated randomized outcome trials.
Osteoarthritis (OA) constitutes one of the leading causes of pain and disability worldwide. The incidence of OA will likely rise over the next few decades, with a significant impact on healthcare costs. Patients with OA are often affected by a number of cardiovascular comorbidities, including hypertension, which is present in approximately 40% of cases. Cyclooxygenase (COX) inhibitors, both nonselective and selective COX-2 inhibitors, are often used to control pain in these patients. Unfortunately, such drugs may cause a variable degree of blood pressure increase. Because even small increases in blood pressure values may lead to a significant increase in the risk of major cardiovascular events and death, the consequent healthcare concerns have led to the development of the COX-inhibiting nitric oxide donator class of drugs. These new drugs are aimed to improve cardiovascular and gastrointestinal safety profiles, as compared with nonsteroidal anti-inflammatory drugs, through the release of nitric oxide.
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Gentile et al. (2011) studied this question.
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