A Comprehensive Review on the Advancements of Dual COX-2/5-LOX Inhibitors as Anti-Inflammatory Drugs

Chronic pain and inflammation are widespread clinical issues that significantly affect patients' quality of life and are often associated with serious conditions such as arthritis, cancer, and cardiovascular disease. Effective management of inflammation is therefore a major public health priority. Current anti-inflammatory treatments—including non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, disease-modifying antirheumatic drugs (DMARDs), and biologics—offer symptomatic relief but are frequently limited by side effects such as gastrointestinal toxicity, immunosuppression, or cardiovascular risks. Moreover, most of these therapies target only a single pathway in the inflammatory cascade. Dual inhibitors of COX-2 and 5-LOX have emerged as a promising therapeutic class, as they simultaneously block two key enzymes involved in prostaglandin and leukotriene synthesis. This dual-action approach offers enhanced efficacy and may reduce adverse effects linked to selective or non-selective COX inhibition. This review discusses the underlying mechanisms of inflammation, evaluates current treatment options, and highlights the pharmacological advantages and development status of dual COX-2/5-LOX inhibitors as a next-generation strategy for inflammation management.