2 drugs - help or not?

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From Reuter's Health section today:

Study questions role of " super aspirins "

NEW YORK, Jun 01 (Reuters Health) -- Recently approved " super-aspirins " may

not be as effective as previously believed at relieving the pain and

inflammation of arthritis, a preliminary study in rodents suggests.

A study in June's issue of Nature Medicine questions whether the so-called

super-aspirin, a new class of arthritis drugs known as cyclooxygenase(COX)-2

inhibitors including Merck's rofecoxib (Vioxx) and G.D. Searle's celecoxib

(Celebrex) help or hinder the treatment of chronic pain in the long run.

The drugs work by selectively blocking the COX-2 enzyme, which is thought to

play a role in causing arthritis pain, without blocking the COX-1 enzyme

which protects the gastrointestinal system.

But a new study of lung inflammation in rats suggests that the COX-2 enzyme

may actually have anti-inflammatory properties later in the inflammation

process, thus blocking it may prolong inflammation in the long-term.

This observation may explain why non-steroidal anti-inflammatory agents

(NSAIDs) alleviate the immediate symptoms of an arthritis flare-up, but do

little to arrest disease progression over time, report a team led by Dr.

Colville-Nash of the department of experimental pathology at

the Harvey Research Institute in London.

Colville-Nash and colleagues found that COX-2 is associated with an

inflammatory reaction during the early phase of an inflammatory response, at

two hours. The surge of this enzyme, however, occurs later in the

inflammatory process, at 48 hours and is actually shown to have

anti-inflammatory effects in the rats studied.

At 48 hours, COX-2 expression was 350 times greater than at two hours, the

study showed.

While drugs including the new COX-2 inhibitors and older arthritis

medications do alleviate the inflammation early on, they tend to aggravate

inflammation at 48 hours, the study found.

The team also suggest that their findings may lead to changes in how NSAIDs

are prescribed for arthritis pain, " removing or reducing their use during

periods of remission rather than their continuous application may improve

their efficacy in controlling chronic inflammatory diseases. "

In an editorial accompanying the new report, Seibert and colleagues

from GD Searle and Company, based in Skokie, Illinois, point out that while

the report " raises questions about the roles of COX-2 " , the fact that the

research was conducted in rats, and studied lung inflammation rather than

joint diseases raises issues such as species and tissue differences in

cellular responses.

" The final analysis, as always, will come from clinical (human) data, " they

conclude.

SOURCE: Nature Medicine 1999;5: 621-622, 698-701 "

Mark

http://members.tripod.com/~Mark_Holmes

RA 4/98 AP 7/98

Minocycline (Lederle generic) 100mg 2x/day; Lodine 400mg 3x/day

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