View source for COX-inhibiting nitric oxide donator

'''COX-inhibiting nitric oxide donators''' ('''CINODs'''), also known as '''NO-NSAIDs''', are a new class of [[non-steroidal anti-inflammatory drug]] (NSAID) developed with the intention of providing greater safety than existing NSAIDs.

These compounds were first described by John Wallace<ref>[http://www.ucalgary.ca/irn/wallace.htm John Wallace, Professor, Department of Pharmacology and Therapeutics, University of Calgary]</ref> and colleagues.  CINODs are [[Chemical compound|compound]]s generated by the fusion of an existing NSAID with a [[nitric oxide]] (NO)-donating [[functional group|moiety]] by chemical means, usually by [[Ester#Ester_reactions|ester linkage]].  CINODs retain the [[anti-inflammatory]] efficacy of NSAIDs via inhibition of [[cyclooxygenase]] (COX) while arguably improving upon gastric and vascular safety, most likely via [[vasorelaxation]], inhibition of [[leukocyte]] [[cell adhesion|adhesion]] and inhibition of [[caspases]], all known effects of NO. 

The first CINODs were developed in the 1990s, and as yet none have been approved for use by the general public.  The importance of developing such drugs was increased when [[COX-2 inhibitor|COX-2-specific NSAIDs]] [[rofecoxib]] (Vioxx) and [[lumiracoxib]] (Prexige) were removed from major pharmaceutical markets in the mid-2000s due to [[COX-2 inhibitor#Risks and adverse effects|vascular safety concerns]].  In addition, traditional NSAIDs increase [[blood pressure]] and interfere with the actions of [[antihypertensive]] drugs. Several CINODs are currently being tested in [[clinical trials]], the most advanced of which are being conducted by the [[France|French]] [[pharmaceutical company]] [[NicOx]], whose flagship compound [[naproxcinod]] (NO-naproxen, nitronaproxen) is in [[clinical trials#Phase III|phase III trials]] for the treatment of [[osteoarthritis]].<ref>[http://www.drugdevelopment-technology.com/projects/azd3582/ HCT 3012 - COX-Inhibiting Nitric Oxide-Donator (CINOD) for Relief of Pain and Inflammation]</ref>  Naproxcinod is a fusion of [[naproxen]] and a NO-donating group.  Other CINODs are also being tested by NicOx for the treatment of diseases in which inflammation plays a role.<ref>[http://www.nicox.com/update/portfolio.html NicOx pipeline: product portfolio]</ref>

==References==
{{Reflist}}
* Wallace JL, Reuter BK, Cicala C, McKnight W, Grisham MB, Cirino G.  Novel nonsteroidal anti-inflammatory drug derivatives with markedly reduced ulcerogenic properties in the rat.  [[Gastroenterology]] 1994; 107: 172-179. PMID 8020659 
* Wallace JL, Cirino G.  The development of gastrointestinal-sparing anti-inflammatory drugs.  [[Trends Pharmacol Sci]] 1994; 15: 405-406. PMID 7855901 
* Keeble JE, Moore PK. Pharmacology and potential therapeutic applications of nitric oxide-releasing non-steroidal anti-inflammatory and related nitric oxide-donating drugs. [[Br J Pharmacol]] 2002;137:295-310. PMID 12237248 
* White, WB. Cardiovascular effects of the cyclooxygenase inhibitors. [[Hypertension]] 2007; 49(3):408-18. PMID: 17261646 [http://hyper.ahajournals.org/cgi/reprint/49/3/408]

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{{Analgesics}}

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[[Category:Non-steroidal anti-inflammatory drugs]]


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