A Little Aspirin Might Rescue -2 Inhibitors

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Aspirin Might Counter Side Effects of -2 Painkillers

By Randy Dotinga

HealthDay Reporter

TUESDAY, Sept. 13 (HealthDay News) -- Few prescription drugs have as

tarnished a reputation as Vioxx, the painkiller that was removed from

the market last September amid reports that it caused heart attacks.

Now, however, researchers are reporting that an old, inexpensive

standby -- aspirin -- may actually reduce the nasty cardiovascular

effects of Vioxx and its sister medications.

The research was only done in mice, and tests in humans appear to be

out of the question. Still, the findings show promise that aspirin

could come to the rescue of painkillers known as cox-2 inhibitors,

said study senior author Dr. Coffman, chief of division of

nephrology at Duke University in Durham, N.C. " It's at least an idea

that we think has some merit. "

Last September, Merck & Co. withdrew its billion-dollar blockbuster

drug Vioxx from the market. Two similar drugs -- Celebrex and Bextra

-- have also come under fire, and the FDA pulled Bextra from the

market last spring. Celebrex is still available, but carries

heightened label warnings about cardiovascular side effects.

-2 inhibitors are heavy-duty painkillers designed to provide

relief without triggering gastrointestinal problems -- unlike

aspirin, which can cause stomach bleeding. Similar to aspirin, cox-2s

interfere with chemical pathways that contribute to pain in the body.

But like an rescue force that can cause destruction even as it brings

relief to a community, some of these drugs seem to also make the body

more prone to high blood pressure and other cardiovascular problems.

Essentially, the drugs inhibit a " good guy " hormone, which widens

blood vessels and thins blood, and does nothing to a " bad guy "

hormone, which constricts blood vessels and makes blood form

dangerous clots, Coffman explained.

In the new study, Coffman and his colleagues genetically engineered

mice to see what would happen if they tinkered with the hormones.

They report their findings in the September issue of Cell Metabolism.

The researchers found that inhibiting both hormones -- the good and

the bad -- is safer for the heart, Coffman said. Low doses of aspirin

could make that happen by thinning the blood, he said.

But where can researchers go from here? To test the theory behind the

study, researchers would need to recruit cox-2 inhibitor users and

assign some to take low-dose aspirin and some to take a placebo, said

Dr. , director of noninvasive cardiology at Brigham and

Women's Hospital in Boston. In addition to gauging whether the

approach reduces cardiovascular problems, it would also reveal if the

aspirin boosts stomach bleeding, he said.

But such a study may be unlikely given the reputation of the cox-2

inhibitors.

Instead, study co-author Coffman said it makes the most sense to use

the new knowledge to develop new drugs.

The study was funded by the National Institutes of Health and the

medical arm of the Veterans Administration.

More information

To learn more about cox-2 drugs, visit the U.S. Food and Drug

Administration.