The evolving NSAID: focus on lornoxicam

It is a sobering thought that many of the effective medicines in use today did not originate from intellectualism, but were culled from the hedgerows and derived from ancient folklore remedies. The nonsteroidal anti-inflammatory drugs (NSAIDs), which currently command the world-wide attention of industrialists, economists, stock market analysts, researchers and physicians alike, represent a category of drugs with origins that are truly lost in antiquity and myth. In accepting the ubiquitous nature of these compounds to inhibit cyclooxygenase (COX) activity, we should not overlook the rich structural End pharmacological diversity which, likewise, is a hallmark of this category. With our greater understanding of both peripheral and central processing of nociceptive input, the opportunities exist to explore the clinical significance of such diversity. Interest in undertaking such new studies, however, will ultimately be driven by the need to provide greater benefit to the patient. If such goals are not in sight, then, understandably, research-funding incentives will become limited for compounds that may be viewed as less exciting than the newest basic science hypotheses. More than any other group of NSAIDs, it is the oxicams that provided us with renewed optimism to witness the effects of this structural diversity, adding impetus to research interest in the search for more effective and better tolerated agents. In this review I examine the newest launch (1997) from the oxicam group, lornoxicam. This article is not intended as an exhaustive overview of the lornoxicam literature. Rather, I focus on issues that characterize and distinguish the scientific evolution of lornoxicam from its modern oxicam heritage and its generic origins in myth and folklore.