'Vioxx Like' Drugs May Still Be Best Option For Arthritis

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Source: Imperial College London

Date: 2006-01-19

URL: http://www.sciencedaily.com/releases/2006/01/060118214940.htm

'Vioxx Like' Drugs May Still Be Best Option For Arthritis, Write

Scientists

Scientists believe that despite the current concerns around anti-

inflammatory drugs like Vioxx, they may still be the best option for

treating some forms of arthritis.

In a Nature Reviews of Drug Discovery article this month the

researchers from Imperial College London and Queen , University

of London examine the use of selective inhibitors of cyclo-oxygenase-

2 (COX-2).

They argue that although this class of drugs, which includes Vioxx,

has been associated with an increase in the risk of cardiovascular

events such as heart attacks and strokes in some patients, the same

may be true for traditional non-steroid anti-inflammatory drugs

(NSAIDs).

All NSAIDs, including COX-2 inhibitors, work by blocking the actions

of both COX-1 and COX-2 enzymes. Blocking COX-2 relieves

inflammation and pain, but blocking COX-1 can increase the risk of

gastric ulcers and bleeds. For this reason COX-2 selective drugs

were developed with the simple aim that they would retain the

therapeutic actions of NSAIDs (linked to inhibition of COX-2) but

lose the gastric side effects (linked to inhibition of COX-1).

The researchers reviewed over one hundred papers on the subject and

looked at the latest recommendations from organisations such as the

American Federal Drugs Administration on the use of COX-2 inhibitors

and NSAIDs.

The researchers point out that the calls for the removal of COX-2

inhibitors, and a return to using NSAIDs, may cause additional

problems. Although NSAIDs have been marketed for a number of years,

they have never been required to meet the clinical trial standards

now set for COX-2 inhibitors, meaning they may not be any safer.

Professor Jane , from Imperial College London, and one of

the reviews authors, said: " Although some COX-2 drugs have been

reported to increase the risk of heart attack and stroke, they may

still remain the best option for treating arthritis in some patients

without cardiovascular risk factors who cannot tolerate traditional

NSAIDs because of gastric side effects. "

Professor added: " This review shows us that despite the

large scale use of NSAIDs and COX-2 inhibitors for a number of

years, we still need more information on their benefits and

potential risks and that more research needs to be done in this

area. Looking at existing evidence, however, it would seem COX-2

inhibitors may be the best option for some patients. They are as

effective as traditional NSAIDs, but with less gastric side effects

than some older drugs. "