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Polmacoxib is a first-in-class, orally active nonsteroidal anti-inflammatory drug (NSAID) approved for the treatment of osteoarthritis and investigated for colorectal cancer. It acts as a dual inhibitor of cyclooxygenase-2 (COX-2) and carbonic anhydrase (CA), distinguishing it from other NSAIDs. This dual mechanism allows polmacoxib to selectively inhibit COX-2 in inflamed tissues—where CA is deficient—thus reducing inflammation and pain, while its high affinity for CA in cardiovascular tissues reduces COX-2 inhibition there, potentially minimizing adverse cardiovascular effects associated with traditional COX-2 inhibitors. Polmacoxib was developed as CG100649 and is marketed under the brand name Acelex[1][2][5][7].
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