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Heart Effects of COX Drugs (Vioxx, Celebrex)
  1. #1
    stingray is offline Junior Member
    Join Date
    Sep 2004

    Default Heart Effects of COX Drugs (Vioxx, Celebrex)

    Study Shows Different Heart Effects of COX Drugs
    Mon Dec 6, 2004 05:01 PM ET

    By Maggie Fox, Health and Science Correspondent
    WASHINGTON (Reuters) - People who take Merck & Co. Inc.'s analgesic Vioxx are nearly three times as likely to have heart attacks as those taking Pfizer Inc.'s Celebrex, according to an independent study published on Monday.

    While this suggests there may be some important differences among the drugs known as COX-2 inhibitors, the researcher who led the study says more work is needed to see whether some COX-2 inhibitors may be safer than others.

    The study is another in a series that have followed the discovery that Vioxx may raise the risk of heart attacks in at least some people who take it.

    The finding was ironic because the COX-2 class of drugs was designed to be safer than older analgesics such as aspirin or ibuprofen, which raise the risk of often fatal stomach or intestinal bleeding.

    "At this point the evidence is that there are differences between Vioxx and Celebrex. Does that mean Celebrex is safe? I cannot tell you," said Dr. Stephen Kimmell of the University of Pennsylvania, who led the study.

    When Kimmell's team compared people who took either Vioxx or Celebrex alone to people taking older analgesics or nothing, they found that neither drug raised the risk of heart attack.

    "That may be a fluke," Kimmell said in a telephone interview.


    Writing in the Annals of Internal Medicine, Kimmell and colleagues said they added the information on COX-2 inhibitors to a government-funded study they were already doing on heart disease and painkillers known as non-steroidal anti-inflammatory drugs, or NSAIDS.

    These include aspirin as well as ibuprofen, naproxen and others. Pfizer and Merck paid for some of the added research but had no input, Kimmell said.

    "We compared 1,718 people with non-fatal heart attack to 6,800 people who did not have heart attacks and asked them about their use of COX inhibitors and NSAIDS," Kimmell said.

    "The main finding is that people who use Vioxx have almost a three-fold higher risk of non-fatal heart attacks as people who use Celebrex," Kimmell said, adding he presumed the statistics for fatal heart attacks would be similar.

    When they looked at Vioxx or Celebrex separately compared to people taking NSAIDS or no analgesic, they found no increased risk of heart attack.

    "That could be because ... we were studying a relatively healthier population (than other studies)," Kimmell said. "Most people were taking (Vioxx or Celebrex) for less than 12 months."

    Some research suggests that the risk only goes up for people already at a higher risk of heart disease, or for people taking the drug for longer. No one is sure about the cause of the increased risk.

    Kimmell and other experts said the studies add to a growing body of evidence that COX-2 inhibitors should only be used by a limited group of people.

    "I think the real question is who should ever have been on these drugs," Kimmell said.

    In a commentary, two Harvard Medical School researchers -- Dr. Axel Finckh, a rheumatologist at Brigham and Women's Hospital and Dr. Mark Aronson of Beth Israel Deaconess Medical Center -- said doctors should avoid prescribing COX-2 inhibitors to patients who have a risk of heart disease.

    "At this time, because we really don't know what is triggering an increased risk of heart problems in patients taking some COX-2 inhibitors, whether it is something within this class of drugs, or something specific to each individual medication, it is prudent for patients at risk for heart disease to seek alternative therapies first," they wrote in the same edition of Annals.

  2. #2
    MONHEIT_LAW_PC is offline New Member
    Join Date
    Dec 2004


    There is no question that among the COX II drugs, Vioxx is the worst. What remains to be determined is how far behind Bextra and Celebrex are. Also, there are new Cox II drugs awaiting approval, and it is unclear whether these drugs should ever make it to market. What makes these drugs even more dubious, beyond the fact that they cost a small fortune to buy, is that it is not clear that they help pain any more than drugs that have been on the market for 20+ years and cost much less!

    It seems to me that these drugs were nothing more than an excuse for Pharma companies to charge more.
    Michael Monheit, Esquire
    Monheit Law, PC

  3. #3
    gooddaughter is offline New Member
    Join Date
    Jan 2005
    United Kingdom.


    Coming from the UK, we have not heard about the uproar on vioxx. Can u tell me if the issue is with a particular strength, and others are ok ie: issue is with 15mg dose, but 60mg ok, or is it the entire drug that is in question. I have a relative who has a history of heart disease in the family and is on a number of medications for hypertension, arthritis, and pain, and want to arm myself with as much info as possible to confront our GP.

    Have the USA withdrawn the drug totally?

    Many thanks.

    v canchon

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