Now Celebrex Too?

I don't blog much on medicine.  Here's something worth noting, though.  Pfizer has noted increased heart attack risk with Celebrex, another "COX 2 inhibitor", like Vioxx, though won't be pulling it from the market.  And apparently Bextra also.

Dr. Marie Griffin, an epidemiologist and drug safety expert at Vanderbilt University, said the new findings on Celebrex is worrisome evidence suggesting that all these cox-2 drugs have similar risks.

However, she noted that the halted study was testing an 400 to 800 milligram dose — four times the usual dose — and that the safety problem with Celebrex may only apply to those high levels...

Griffin and two other Vanderbilt epidemiologists also raised fresh concerns about Bextra, Pfizer's other cox-2, in a letter to be published Thursday in the New England Journal of Medicine.  Doctors should not prescribe the drug "except in extraordinary circumstances," they recommend.

Problems in medicine are never as straightforward as the public would like.  There is, with any medical intervention, a balancing act.  What are the risks involved in the proposed care vs. the risks of alternatives, and what are the benefits of each.  In the case of Celebrex and Vioxx (and Bextra for that matter) there appears to be a higher risk of heart problems.  But for many arthritis sufferers these were very effective drugs that were also otherwise very well tolerated.  Thousands die each year from gastrointestinal bleeding often attributed to NSAID use, and these drugs had a reduced risk profile for that complication.

The bottom line is that there is no perfectly safe drug that effectively treats all patients with arthritis.  The best you can hope for is to trust your physicians and speak with them when starting a medication, particularly if it will be long term.  And be honest with your doctor, giving your full medical history.  Monitor your own situation, don't ignore symptoms, and let the doctor know if you have problems with the medicine.

And with the higher risk of heart disease causing the downfall of these medications, managing arthritis just became more difficult.