伊瑞昔布是一种环氧合酶-2 (COX-2) 选择性非甾体抗炎药 (NSAID)，是通过 COX-1/COX-2 的平衡抑制策略发现的。它适用于缓解骨关节炎的疼痛症状。自2011年批准imrecoxib以来，已经取得了一些药理学和治疗进展。然而，目前尚无这方面的更新综述。通过PubMed、Web of science、Embase、CNKI检索找到截至2024年1月的相关文献。从疗效角度来看，伊瑞昔布可缓解骨关节炎症状，并有可能超适应症用于治疗特发性肺纤维化、围手术期疼痛、手足综合征、中轴型脊柱关节炎、COVID-19、软骨损伤以及肺癌等恶性肿瘤。结肠癌。从安全角度来看，伊瑞昔布表现出非甾体抗炎药常见的不良反应；但其新发高血压发生率低于其他类型选择性COX-2抑制剂，胃肠道毒性低于非选择性NSAID，药物相互作用风险低于塞来昔布，且由于平衡抑制COX而更适合老年患者-1/COX-2。从药物经济学的角度来看，对于骨关节炎患者来说，伊瑞昔布比塞来昔布和双氯芬酸更具成本效益。随着骨关节炎疾病病理生理学研究的不断深入，新的治疗方案和药理机制不断被发现。在骨关节炎治疗领域，COX-2抑制剂的镇痛和抗炎作用以外的机制也在探索中。综合来看，imrecoxib是一种中等选择性的COX-2抑制剂，具有一定的优势，未来会有更多的临床应用和研究机会。© 2024 Wang et al.

Imrecoxib, a cyclooxygenase-2 (COX-2) selective non-steroidal anti-inflammatory drug (NSAID), was discovered via the balanced inhibition strategy of COX-1/COX-2. It is indicated for the relief of painful symptoms of osteoarthritis. There have been some pharmacological and therapeutic advances since the approval of imrecoxib in 2011. However, an update review in this aspect is not yet available. Relevant literature until January 2024 was identified by search of PubMed, Web of science, Embase and CNKI. From the perspective of efficacy, imrecoxib provides relief of osteoarthritis symptoms, and potential off-label use for treatment of idiopathic pulmonary fibrosis, perioperative pain, hand-foot syndrome, axial spondyloarthritis, COVID-19, cartilage injury, and malignancies such as lung and colon cancer. From a safety point of view, imrecoxib showed adverse effects common to NSAIDs; however, it has lower incidence of new-onset hypertension than other types of selective COX-2 inhibitors, less gastrointestinal toxicities than non-selective NSAIDs, weaker risk of drug interaction than celecoxib, and more suitable for elderly patients due to balanced inhibition of COX-1/COX-2. From a pharmacoeconomic perspective, imrecoxib is more cost-effective than celecoxib and diclofenac for osteoarthritis patients. With the deepening of the disease pathophysiology study of osteoarthritis, new therapeutic schemes and pharmacological mechanisms are constantly discovered. In the field of osteoarthritis treatment, mechanisms other than the analgesic and anti-inflammatory effects of COX-2 inhibitors are also being explored. Taken together, imrecoxib is a moderate selective COX-2 inhibitor with some advantages, and there would be more clinical applications and research opportunities in the future.© 2024 Wang et al.