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Dec 17, 2004 (WCCO) The company that makes Celebrex said it, too, could lead to heart problems. When Celebrex and other drugs like it came out, they seemed to be the magic pill for what ailed arthritis sufferers. The class of drugs is called Cox-2 Inhibitors reduced inflammation and pain without causing nasty side effects. "They're less irritating to the stomach. That's was the whole point of promoting this drug over older drugs that are less expensive.” Keith Thorkelson, a pharmacist said

One of these drugs Vioxx had to be pulled from the market due to an increased risk of heart attack. Pharmacy tech Ann Stoneman had to stop taking Vioxx and now she said she's glad she didn't start taking Celebrex. "I would rather be safe than sorry at my age heart problems would be a whole lot more prevalent, I just don’t want to cause any problems.” Stoneman said.

Celebrex's manufacturer Pfizer says one study shows an increased risk of heart attacks with patients taking a large amount of the drug. The company is not pulling Celebrex off the market, which puts doctors and patients in a tough position. "It means we really have to think had whether they should be on a category of drug like this.” Dr. Eugene Ollila said.

Ollila said patients with heart and kidney conditions may want to reconsider taking Celebrex. He said it may be time to look at other ways like therapy to ease the pain without the pills. "We'll have to open that book up a lot more than just here take a pill and go on your merry way.” Ollila said. The study showed increased risk of heart attack with a dose of 400 to 800 milligrams of Celebrex. Most arthritis patients take far less.

Dr. Ollila's advice, if you're taking 100 to 200 milligrams, it's probably fine to continue taking Celebrex but you may want to talk to your doctor about other options.

Studies show COX-2 arthritis painkillers increase risk of heart attacks

April 24, 2005 - A pair of studies demonstrates that some popular arthritis painkillers may lead to an increased risk of heart attacks and strokes. One study showed patients who had had heart bypass surgery and were taking Bextra were three times more likely to have strokes and heart attacks. A second study showed that when mice were treated with an arthritis drug and an aspirin substitute, their hardening of the arteries worsened. Related articles on this topic are also available on the NewsTarget Network, including: Long-term use of Tylenol (acetaminophen) found to cause kidney damage, says new study.

Original news summary: (http://www.washingtonpost.com/wp-dyn/articles/A16166-2005Jan17.html)

Overview:

• Two studies released yesterday have turned up new evidence that all of the popular arthritis painkillers known as COX-2 inhibitors may put users at greater risk of heart attacks and strokes.

• The first of the two papers published online by the journal Circulation found that patients who had had heart bypass surgery and were taking Pfizer Inc.'s Bextra and another experimental COX-2 inhibitor were three times more likely to have strokes and heart attacks than patients taking a placebo.

• A second study found that when mice that are genetically prone to hardening of the arteries were treated with a COX-2 drug and an aspirin substitute, their condition worsened rather than improving, as researchers had anticipated.

• Lead researcher Garret A. FitzGerald of the University of Pennsylvania said the two studies led him to conclude that the entire class of drugs poses a risk.

• He also said that an upcoming clinical trial proposed by Pfizer to test whether its drug Celebrex may help patients with heart disease should not go forward.

• The latest bad news for makers and users of COX-2 drugs comes a month before the Food and Drug Administration is scheduled to hold an unusual three-day hearing Feb. 16 to 18 of two advisory panels to consider the safety issues that have arisen around the entire class of drugs.

• Planning for the meeting began in the fall when Pfizer took its blockbuster COX-2 drug Vioxx off the market after a study it sponsored found heightened cardiovascular risk in volunteers taking the drug.

• Since then, federal officials have been formally reviewing the risks of using Celebrex in more than 40 federally sponsored studies into other potential uses of the drug.

• FitzGerald acknowledged that tests in mice might not be fully applicable to humans, but he also noted that the earliest evidence of cardiovascular risks associated with COX-2 drugs also came from animal experiments.

Source: http://www.washingtonpost.com/wp-dyn/articles/A16166-2005Jan17.html

Bad Medicine - Some Arthritis Sufferers Say Added Risks of Vioxx, Celebrex Are Better Than the Pain

PEORIA - The possibility of having a heart attack from taking arthritis medicine doesn't worry former Vioxx user Sharon Richmond - she's had three before.

"I've had three heart attacks in the past, before I ever even heard of Vioxx," Richmond, a former nurse, said of the arthritis drug that was recently pulled from the market by its maker because of heart-related health concerns.

"I'm not worried about it. It's been 15 years since I've had a heart attack," she said.

"Vioxx was a good medicine. My doctor evidently felt that it was a small risk, and he kept tabs on my heart."

Richmond, 65, suffers from osteoarthritis in her right shoulder and left hip. She took Vioxx for two years, but when the drug was pulled from the market, she had to find an alternative for her pain relief.

"I was really more upset I had to go back to the pain," she said.

Now, the safety of over-the-counter pain reliever Aleve has come into question after a study of Alzheimer's patients showed a possibility of increased heart problems connected with the drug.

The Arthritis Foundation's national office in Atlanta released a statement Tuesday that suggests the findings in the Aleve study are not as troubling as they appear.

"The Arthritis Foundation regards this information as very preliminary and would express caution in over-interpreting these findings. The Arthritis Foundation does not believe that these findings should have any immediate impact on the clinical use of this class of drugs," the statement said of Aleve, also known as naproxen.

Richmond, like many arthritis sufferers, has switched to different arthritis medicines but said they don't work as well as Vioxx did.

She said her arthritis pain wasn't as intense with Vioxx and that her new medication, Mobic, isn't as effective.

"It's not helping. It's no good," she said of Mobic, which she has taken since September. "It hurts to the point it wakes me up."

While shopping, Richmond has to lean on a cart to ease her pain. And on a recent vacation, she had to sit down frequently after walking short distances.

"I'm not as free to move around as I could before," she said.

Richmond saw drug trends and warnings come and go during her 40 years as a nurse. Now, she works part-time as an information specialist for the Arthritis Foundation in Peoria.

"The arthritis medicines are potent. They all can cause problems" if used incorrectly, she said. "I think people jumped to conclusions. People overreacted."

Recently, Pfizer Inc., maker of the arthritis drug Celebrex, announced it found an increased risk of heart problems associated with their drug.

Bob Antonacci, owner and pharmacist of The Medicine Shoppe on Knoxville Avenue, has been dealing with arthritis sufferers who are frustrated with the recent changes.

"I would estimate 20 percent of my time has been spent answering questions about (arthritis medicine)," he said. "There's almost this attitude of 'Well, I guess everything will kill ya.' It's just about to that level of frustration."

Antonacci said he has seen doctors prescribing more Tylenol, which he said isn't very effective for treating arthritis.

"Most of these people have osteoarthritis. Tylenol is just not enough to help," he said. Other arthritis medicines are available and can cost anywhere from $30 to $80 a month.

"There are a lot of people who have been switched over to Relafan," which comes in a generic form and costs about $50 a month, he said. "These people have got to have something. Some of them are in pretty bad shape."

Source: Journal Star; Peoria, Ill.

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