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Vol. 290, Issue 2, 551-560, August 1999
Departments of Pharmacology, Biochemistry and Molecular Biology,
and Medicinal Chemistry, Merck Frosst Centre for Therapeutic Research,
Kirkland, Quebec, Canada (C.-C.C., C.B., S.C., W.C., D.E., J.E.,
A.W.F.-H., J.Y.G., R.G., M.G., J.G., S.K., B.K., Y.L., S.L., J.M.,
G.P.O., M.O., M.D.P., H.P., P.P., I.R., P.T., M.T., P.V., Z.W., E.W.,
L.-J.X., R.N.Y., R.Z., D.R.); Department of Pharmacology, Merck
Research Laboratories, Harlow, UK (S.B., J.W.); Department of
Pharmacology, Merck Research Laboratories, Rahway, New Jersey (M.J.F.,
D.V.); and Safety Assessment, Merck Research Laboratories, West Point,
Pennsylvania (D.P.)
The discoveries that cyclooxygenase (COX)-2 is an inducible form
of COX involved in inflammation and that COX-1 is the major isoform
responsible for the production of prostaglandins (PGs) in the
gastrointestinal tract have provided a rationale for the development of
specific COX-2 inhibitors as a new class of anti-inflammatory agents
with improved gastrointestinal tolerability. In the present study, the
preclinical pharmacological and biochemical profiles of rofecoxib
[Vioxx, also known as MK-0966,
4-(4'-methylsulfonylphenyl)-3-phenyl-2-(5H)-furanone], an orally active COX-2 inhibitor, are described. Rofecoxib is a potent
inhibitor of the COX-2-dependent production of PGE2 in human osteosarcoma cells (IC50 = 26 ± 10 nM) and
Chinese hamster ovary cells expressing human COX-2
(IC50 = 18 ± 7 nM) with a 1000-fold selectivity
for the inhibition of COX-2 compared with the inhibition of COX-1
activity (IC50 > 50 µM in U937 cells and
IC50 > 15 µM in Chinese hamster ovary cells
expressing human COX-1). Rofecoxib is a time-dependent inhibitor of
purified human recombinant COX-2 (IC50 = 0.34 µM)
but caused inhibition of purified human COX-1 in a non-time-dependent
manner that could only be observed at a very low substrate
concentration (IC50 = 26 µM at 0.1 µM arachidonic acid concentration). In an in vitro human whole blood assay, rofecoxib selectively inhibited lipopolysaccharide-induced, COX-2-derived PGE2 synthesis with an IC50 value of 0.53 ± 0.02 µM compared with an IC50 value of 18.8 ± 0.9 µM for the inhibition of COX-1-derived thromboxane B2
synthesis after blood coagulation. Using the ratio of the COX-1
IC50 values over the COX-2 IC50 values in the
human whole blood assay, selectivity ratios for the inhibition of COX-2 of 36, 6.6, 2, 3, and 0.4 were obtained for rofecoxib, celecoxib, meloxicam, diclofenac, and indomethacin, respectively. In several in
vivo rodent models, rofecoxib is a potent inhibitor of
carrageenan-induced paw edema (ID50 = 1.5 mg/kg),
carrageenan-induced paw hyperalgesia (ID50 = 1.0 mg/kg), lipopolysaccharide-induced pyresis (ID50 = 0.24 mg/kg), and adjuvant-induced arthritis (ID50 = 0.74 mg/kg/day). Rofecoxib also has a protective effect on
adjuvant-induced destruction of cartilage and bone structures in rats.
In a 51Cr excretion assay for detection of gastrointestinal
integrity in either rats or squirrel monkeys, rofecoxib has no effect
at doses up to 200 mg/kg/day for 5 days. Rofecoxib is a novel COX-2 inhibitor with a biochemical and pharmacological profile clearly distinct from that of current nonsteroidal anti-inflammatory drugs and
represents a new therapeutic class of anti-inflammatory agents for the
treatment of the symptoms of osteoarthritis and rheumatoid arthritis
with improved gastrointestinal tolerability.
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