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Doctors Say Avoid Pfizer's Bextra -Medical Journal
Doctors Say Avoid Pfizer's Bextra -Medical Journal -- Posted by Roman Bystrianyk on 12-17-04 19:25
http://www.healthsentinel.com/news.php?event=news_print_list_item&id=481
Kim Dixon, "Doctors Say Avoid Pfizer's Bextra -Medical Journal",
Reuters, December 17, 2004,
Link:
http://www.reuters.com/newsArticle.jhtml;jsessionid=XMHADVG3NAGZUCRBAEOCFEY?type=healthNews&storyID=7128851
Doctors writing in a prominent medical journal on Friday recommended
that physicians stop prescribing Pfizer Inc.'s Bextra painkiller, just
as a large study found the drug maker's sister drug, Celebrex, doubled
risk of heart attacks.
Both drugs are members of the so-called COX-2 inhibitor class of
painkillers, which recently gained notoriety when Merck & Co. Inc.
withdrew Vioxx in September after a study found it doubled the risk of
heart attack and stroke.
A letter by three top doctors published in The New England Journal of
Medicine said that in light of Vioxx and negative signs on Bextra,
Bextra should be avoided.
"We believe the doubts raised about the safety of valdecoxib (Bextra),
constitute a potential imminent hazard to public health" and thus they
should be prescribed only in "extraordinary circumstances," editorial
writers at The New England Journal of Medicine wrote in an issue dated
Dec. 23, but released early.
Earlier on Friday, Pfizer, the world's No. 1 drug maker, said a
government-sponsored trial of Celebrex was halted after patients taking
the medicine had more than twice as many heart attacks as patients
taking a placebo.
The developments are rekindling debate over the merits and safety of
the entire class of painkiller drugs, doctors interviewed by Reuters
said.
"I'm a cardiologist and I take note of these findings from this trial,
which say there is harm, and I am supposed to 'do no harm,"' said Marc
Pfeffer, a doctor at Brigham and Women's Hospital in Boston, who
advised researchers on the Celebrex study on the heart effects.
Pfeffer and other top doctors said they will not be prescribing the
drugs for their patients.
NO TO COX-2s
Pfizer, for its part, has aggressively defended Bextra and Celebrex
since Vioxx's withdrawal and questions about safety arose. A spokesman
at Pfizer said the company had not seen the medical journal letter and
could not comment.
The company has put out at least four press releases defending the
safety of Bextra and Celebrex since the Sept. 30 recall of Vioxx by
Merck.
Chief Executive Hank McKinnell again defended the drug class and said
in a Friday television interview that there should not be a rush to
judgment because of the findings.
The authors of The New England Journal of Medicine letter are doctors
at the Vanderbilt University School of Medicine. They said they made
the recommendation in light of the long lag time between when evidence
emerged on Vioxx and its withdrawal, coupled with two negative studies
suggesting Bextra boosts heart problems in bypass patients by a factor
of three.
Older cheaper painkillers such as aspirin are as effective as the
COX-2s, but can upset some stomachs.
Jonathan Kay, associate clinical professor at Harvard Medical School
and a rheumatologist at Massachusetts General Hospital, uses
painkillers as a cornerstone treatment for his rheumatoid arthritis
patients.
He said the key advantage of using COX-2 inhibitors -- protecting the
stomach in patients with gastrointestinal problems -- can be avoided by
prescribing a separate medication to prevent stomach upset.
"This data about Celebrex certainly raises enough concern that all
physicians should be very cautious," Kay said.
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