Research in mice suggests that a newer class of painkilling drugs called COX-2 inhibitors could trigger a chain of events potentially harmful to the cardiovascular system.
Researchers speculate, though, that their findings might explain the outcome of a recent major trial in which patients taking a COX-2 inhibitor -- the arthritis drug Vioxx -- had higher rates of heart attack and other cardiovascular complications compared with patients on naproxen.
Naproxen, used in painkillers such as Aleve, belongs to a group of drugs known as nonsteroidal anti-inflammatory drugs (NSAIDs), which includes many familiar painkillers such as aspirin and ibuprofen. Aspirin is also well known for its heart-healthy blood-thinning effects.
COX-2 inhibitors -- which besides Vioxx include the arthritis drugs Celebrex, among others -- are a newer type of NSAID shown to be easier on the stomach. Unlike older forms such as aspirin, they work by selectively blocking the COX-2 enzyme. Traditional NSAIDs inhibit both the COX-2 and COX-1 enzymes, and this is believed to underlie the gastrointestinal side effects that can come with the drugs.
But the new mouse research suggests that the selectivity of COX-2 inhibitors could create an imbalance that promotes blood clotting and blood vessel constriction.
COX-1 makes thromboxane A2, which promotes blood vessel constriction and "stickiness" in blood cells called platelets. COX-2 is the major source of prostacyclin, which helps prevent platelets from clumping and promotes blood vessel dilation.
The researchers hypothesized that the heart-healthy ways of prostacyclin might counter the ill cardiovascular effects of thromboxane A2 in the body -- meaning that blocking only COX-2, and therefore prostacyclin, could allow thromboxane A2 to go about its business unchecked.
The researchers found that mice without a PGI2 receptor -- which mimics the clinical effect of taking COX-2 inhibitors -- had an enhanced vascular response to injury and showed increased thromboxane A2 formation and platelet activation. This exaggerated response was canceled out in mice lacking both thromboxane A2 and PGI2 receptors
Recently Merck & Co. Inc., the maker of Vioxx, announced that the arthritis drug's labeling would be changed to state that it carries higher cardiovascular risks than naproxen -- a move required by the US Food and Drug Administration following the Vioxx-naproxen trial.
However, that labeling also highlights data from two other studies showing that Vioxx users had a lower rate of cardiovascular problems compared with study participants taking an inactive placebo, although the difference was not statistically significant.
Science April 19, 2002;296:539-541
Folks, I announced this warning in January 1999, over three years ago when it was first published by the National Academy of Sciences. That is one of the benefits you receive by reading this newsletter. You will find out the medical facts that will be making headlines in the future.
The market for analgesics is about TEN BILLION dollars per year. That is one big number. That is why these are important drugs to watch. It is important to remember that anytime you are dealing with numbers that large there will inevitably be corruption, greed and negative influences that are a part of the story if drugs are involved.
Originally, these drugs were thought to decrease the risk of ulcers. However, an FDA Advisory Panel has since found that these drugs do NOT decrease one's risk of developing ulcers.
They also appear to be associated with an increase in damage to the kidneys.
Now we find more evidence that, as I said in 1999, these drugs also increase one's risk of heart disease. I do want to put the increased heart attack risk in its proper perspective. Although they appear to double the risk of heart disease, the overall risk is still quite low.
The drugs can likely still be used as a temporary measure while one is working on the cause of the problem. If one is following the proper eating plan, it is likely that the small increase in heart disease will not occur due to the other changes that occur in one's biochemistry due to eating properly. This is primarily related to normalization of insulin levels that corrects thousands of chemical pathways that would affect heart disease risk.
Additionaly, it is important to recognize that my revised eating plan has a strong emphasis on omega-3 fats which influence the good prostaglandins in your body. Prostaglandins are chemicals that you body makes and can either promote or prevent inflammation.
In fact that is how Vioxx and Celebrex and all the other anti-inflammatories like aspirin work. They impair the prostaglandin pathways.
You can create your own anti-inflammatory just by changing the ratio of omega-6 to omega-3 fats in your diet. Folks this is non-controversial and there are dozens and dozens of studies which clearly demonstrate this. Even traditional medicine has firmly embraced these concepts.
I review many controversial topics, but there is no disagreement on this one, virturally everyone acknowledges that omega-3 fats play a crucial role in arthritis. If you need guidelines on how to use them please review my comments on Dr. Connor's excellent article.
However, this story does demonstrate the dangers of using these drug band-aids as a permanent "fix" for the problem. They may actually seem to work, but they work at a huge price, both economically and physically. Does one really want to trade joint pain for a heart attack?
Having stated that, the pain in many conditions can be quite severe. Fortunately there are simple basic solutions for over 95% of the conditions that you would be taking these drugs for.
The first step, of course, is to follow the eating plan.
Next would be NST which works incredibly well for both osteoarthritis (DJD) and rheumatoid arthritis (RA).
For severe rheumatoid arthritis I have found my revision of Dr. Brown's protocol useful in producing remission in over 2,000 patients with RA that I have cared for in the last 13 years.
Related Articles:
Celebrex and Vioxx Increase Heart Disease Risk Common Anti-Inflammatory Can Cause Non-Bacterial Meningitis Drug Company Lies About Celebrex in JAMA COX-2 Drugs May Damage Kidneys Celebrex Not Shown to Lower Ulcer Risk
Celebrex and Vioxx Increase Heart Disease Risk
Common Anti-Inflammatory Can Cause Non-Bacterial Meningitis
Drug Company Lies About Celebrex in JAMA
COX-2 Drugs May Damage Kidneys
Celebrex Not Shown to Lower Ulcer Risk