Celebrex, one of my old mainstay drugs for acute gout attacks, is a member of a class of drugs called COX-2 inhibitors. It is considered superior to traditional NSAIDs such as ibuprofen (Advil) and naproxen (Aleve), because those block both COX-1 and COX-2; COX-1 inhibition is what traditionally causes the gastric side effects of NSAIDs.
However, with Merck's recent recall and suspension of Vioxx, their COX-2 offering, the FDA is starting to call into question the risks involved with selective suppression of COX-2, especially on cardiac health. A detailed article from Medscape (free registration required) gives some great details on this, including the following passage:
According to Dr. Wolfe, the COX-2 enzyme has important functions throughout the body, including bone healing, repair of tendon rupture, circulation to the heart, and other protective and restorative roles, especially in emergency situations. "The body needs to be able to produce [the COX-2 enzyme] and use it as part of the healing process," Dr. Wolfe said. "By inhibiting it as the COX-2 inhibitors do, more so than the older NSAIDs, you're asking for trouble.... I think the safe way to go is really not to use any of the drugs in this class, even the ones left after Vioxx is coming off the market."
I think it's important for everyone to take a long, hard look at whether or not COX-2 inhibition is an appropriate treatment mechanism, especially for arthritic conditions.
Comments (3)
I agree we have to look at this carefully. However, Celebrex has never worked for me, and Vioxx did. Since Vioxx was pulled off the market, I have been considerably less mobile, less comfortable, and less capable.
It's hard to navigate issues like this. Obviously, I don't want to take drugs that will end up killing me. On the other hand, I really value the ability to walk down the street, climb a flight of stairs, and be self-sufficient.
Posted by SorchaRei | October 13, 2004 7:16 PM
Posted on October 13, 2004 19:16
You raise a good point, and I suppose I should clarify:
I am never in favor of us having medicines removed from the market for our own good. The whole point of prescription medication is to protect us from inappropriate dosing and utilization. We have run into similar issues when, for example, the FDA removed L-tryptophan from the supplement market, or when they removed phenylpropanolamine (PPA) from the OTC cold medicine market.
I do think, however, that we need to be careful — as both patients and practitioners — about our utilization of these drugs and supplements.
Posted by swansong | October 13, 2004 7:38 PM
Posted on October 13, 2004 19:38
I am not a physician, and this is not medical advice. Please visit my new BLOG - badbonehealing.wordpress.com.
I also have two emails for discussing this info badbonehealing@hvc.rr.com and badbones@hvc.rr.com.
You will be shocked at what you read (i.e. the Merck/Vioxx bone inhibiting information and my personal history). Thank You.
Sincerely,
Dennis Harrison
Posted by Dennis Harrison | September 10, 2006 2:32 AM
Posted on September 10, 2006 02:32