Top Selling Arthritis Drugs Celebrex and Vioxx Could Heighten Risk For Heart Patients
The two top-selling prescription drugs for arthritis could increase the risk of heart attack in some patients, according to an analysis by Cleveland Clinic cardiologists.
In a study published in the August 22, 2001 issue of the Journal of the American Medical Association, the Cleveland Clinic doctors urge physicians to be careful in prescribing Celebrex and Vioxx to patients with coronary artery disease.
The Clinic researchers drew their conclusions after taking a fresh look at four earlier studies that were designed to see how painkillers affected the gastrointestinal system, not the heart.
From that data, they concluded that people who took Vioxx or Celebrex in two of the studies stood a 50 to 60 percent greater chance of having a heart attack or stroke than people in two other studies who took only placebo (sugar pills).
Heart safety is an important issue for the drugs' main users: the elderly and people with rheumatoid arthritis. Both groups are at increased risk of cardiovascular disease.
Although Vioxx and Celebrex are safe and effective for most people, the questions being raised about their possible effect on heart patients demand more study, said Dr. John Klippel, medical director of the Arthritis Foundation.
But Pharmacia Corp., maker of Celebrex, and Merck & Co., which makes Vioxx, said they had not seen an increase in heart attacks and questioned the validity of the Clinic study. Dr. Laura Demopoulos, head of cardiovascular research for Merck, said the Clinic doctors overlooked data from 19 other studies showing that Vioxx did not increase the risk of heart attack.
The heart safety issue of arthritic drugs is currently under review at the Food and Drug Administration. FDA can ask the manufacturers to put precautions (precautions in prescribing the drugs) on the medication, if such precaution is found to be warranted by the results of the review.
In the mean time, prominent doctors are suggesting that heart patients taking Vioxx or Celebrex also take low-dose aspirin to help offset the drugs' tendency to clot blood. Whether that combination is effective is yet to be established.
Last year Celebrex was the ninth-most-prescribed drug in the world. Celebrex and Vioxx had combined sales of $4.5 billion last year and topped $2.6 billion in the first half of this year.