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New Doubts About Celebrex New Doubts About Celebrex -- Posted by R.S. on 12-17-04 21:36
New York Times
December 18, 2004
EDITORIAL
New Doubts About Celebrex
Let's hope that Pfizer isn't falling into the same mind-set that Merck
demonstrated when it stonewalled for years over the safety of its
popular arthritis drug, Vioxx, only to yank it from the market when a
convincing study found it raised the risk of cardiovascular problems.
Yesterday Pfizer announced the results of a government-sponsored
clinical trial, which showed that its own best-selling arthritis drug,
Celebrex, more than doubled or tripled the risk of heart attacks,
strokes and cardiovascular deaths, depending on the dosage.
The company found all sorts of ways to express uncertainty over the
meaning of these findings, calling them "unexpected" and inconsistent
with its own similar trial and other data. It pledged immediate steps
to "fully understand" the results. Yet even before any more data comes
in, it seems clear that patients and doctors must confront the
possibility that this overhyped class of drugs, known as COX-2
inhibitors, may raise the risk of heart problems while offering at
best only limited benefits for some patients. The Food and Drug
Administration, notoriously weak in policing drugs already on the
market, must step in to reduce the dangers.
Vioxx and Celebrex became blockbusters thanks to heavy promotional
campaigns that propelled sales far beyond reason. The ads typically
implied that the drugs provided exceptional pain relief, but in truth
careful clinical trials showed that they were no better in that regard
than such common pain relievers as Advil, Motrin and Aleve.
The presumed advantage of COX-2 inhibitors was that they might cut the
rate of gastrointestinal side effects like ulcers and bleeding. But
the evidence of any benefit is skimpy and seems to be offset by the
heart risks that have driven Vioxx from the market. Those risks have
also led to required new label warnings about Bextra, Pfizer's other
entry in the class, and left Celebrex under a cloud. This is a bizarre
turn of events for drugs taken by millions of Americans in the belief
that they were safer and more effective than older painkillers.
Pfizer said it would not pull Celebrex off the shelves, a stance that
is not surprising given the profits generated by the drug, and the
widespread belief in the industry that Merck only compounded its legal
and financial problems by withdrawing Vioxx. But if Vioxx was risky
enough for Merck to remove from the market, one wonders why Celebrex
should not be yanked as well.
The best hope for an honest assessment of the risks of Celebrex lies
with the F.D.A. and its expert advisory committees. The agency has
been sharply criticized of late for failing to protect the public
adequately against unsafe drugs, especially after the drugs are
already on the market. Its own reputation will be on the line as it
ponders how tough to get about Celebrex in coming days.
Re: New Doubts About Celebrex -- Posted by Sharon Hope on 12-18-04 12:14
All statins had deaths from Rhabdomyolysis. Bayer pulled Baycol
voluntarily. Pfizer continued marketing Lipitor and increased the dosages
recommended and the target populations, as did the other statin
manufacturers. People continue to die from rhabdomyolysis, and continue to
be disabled from myopathy, neuropathy, cognitive damage, memory loss and
amnesia. There have been absolutely no industry studies on a treatment for
these disabled people, nor any studies on how to screen out those who will
be harmed.
Why is anyone surprised that Pfizer, after admitting its other blockbuster
drug, Celebrex, kills and harms some people, will 1) continue to market; 2)
refuse to investigate any treatment to correct the harm done to those who
survive; and 3) refuse to determine the characteristics of those at risk for
death or disability and then screen them out of the potential customer
population?
Is it any wonder that 2/3 of the doctors working for the FDA reported to a
survey that they do not believe the FDA is effectively monitoring drugs for
safety?
The days are past when the Lipitor disabled could be accused of bias in
stating this same belief. The FDA doctors now publicly agree!
The only fix for this situation is for the Congress to revise the way the
FDA is funded. Since Congress made FDA rely nearly entirely on "user fees"
(i.e., a % of the sales of approved drugs), the FDA is in the position of
cutting its own budget if it takes a drug off the market. Conversely, the
only way the FDA can increase its budget is by approving more drugs, or
increasing the markets that can buy the drug.
An example of this in action is the decision by the FDA to increase the
Statin market to Diabetics, immediately after 3 studies by Dr. Gaist were
published showing that statins CAUSE neuropathy. Diabetics have a
particular succeptibility to neuropathy, but a diabetic population consuming
statins meant a larger 'take' for the FDA in user fees.
Congress holds the abilty to put this right. As it is now, both the FDA and
the Drug Cos are playing by the rules, as set by Congress.
"R.S." wrote in message
news:meg7s0dtvjpqpvpt9q9tpsarv9h6itpaor@4ax.com... > New York Times
> December 18, 2004
>
> EDITORIAL
> New Doubts About Celebrex
>
> Let's hope that Pfizer isn't falling into the same mind-set that Merck
> demonstrated when it stonewalled for years over the safety of its
> popular arthritis drug, Vioxx, only to yank it from the market when a
> convincing study found it raised the risk of cardiovascular problems.
> Yesterday Pfizer announced the results of a government-sponsored
> clinical trial, which showed that its own best-selling arthritis drug,
> Celebrex, more than doubled or tripled the risk of heart attacks,
> strokes and cardiovascular deaths, depending on the dosage.
>
> The company found all sorts of ways to express uncertainty over the
> meaning of these findings, calling them "unexpected" and inconsistent
> with its own similar trial and other data. It pledged immediate steps
> to "fully understand" the results. Yet even before any more data comes
> in, it seems clear that patients and doctors must confront the
> possibility that this overhyped class of drugs, known as COX-2
> inhibitors, may raise the risk of heart problems while offering at
> best only limited benefits for some patients. The Food and Drug
> Administration, notoriously weak in policing drugs already on the
> market, must step in to reduce the dangers.
>
> Vioxx and Celebrex became blockbusters thanks to heavy promotional
> campaigns that propelled sales far beyond reason. The ads typically
> implied that the drugs provided exceptional pain relief, but in truth
> careful clinical trials showed that they were no better in that regard
> than such common pain relievers as Advil, Motrin and Aleve.
>
> The presumed advantage of COX-2 inhibitors was that they might cut the
> rate of gastrointestinal side effects like ulcers and bleeding. But
> the evidence of any benefit is skimpy and seems to be offset by the
> heart risks that have driven Vioxx from the market. Those risks have
> also led to required new label warnings about Bextra, Pfizer's other
> entry in the class, and left Celebrex under a cloud. This is a bizarre
> turn of events for drugs taken by millions of Americans in the belief
> that they were safer and more effective than older painkillers.
>
> Pfizer said it would not pull Celebrex off the shelves, a stance that
> is not surprising given the profits generated by the drug, and the
> widespread belief in the industry that Merck only compounded its legal
> and financial problems by withdrawing Vioxx. But if Vioxx was risky
> enough for Merck to remove from the market, one wonders why Celebrex
> should not be yanked as well.
>
> The best hope for an honest assessment of the risks of Celebrex lies
> with the F.D.A. and its expert advisory committees. The agency has
> been sharply criticized of late for failing to protect the public
> adequately against unsafe drugs, especially after the drugs are
> already on the market. Its own reputation will be on the line as it
> ponders how tough to get about Celebrex in coming days.
>
>
>
>
Re: New Doubts About Celebrex -- Posted by listener on 12-19-04 07:26
"Sharon Hope" wrote in
news:_c0xd.283105$R05.59244@attbi_s53:
> All statins had deaths from Rhabdomyolysis. Bayer pulled Baycol
> voluntarily. Pfizer continued marketing Lipitor and increased the
> dosages recommended and the target populations, as did the other
> statin manufacturers. People continue to die from rhabdomyolysis, and
> continue to be disabled from myopathy, neuropathy, cognitive damage,
> memory loss and amnesia. There have been absolutely no industry
> studies on a treatment for these disabled people, nor any studies on
> how to screen out those who will be harmed.
To put this in some perspective:
Deaths reported in Statin-Associated Rhabdomyolysis
(October 1997 through December 2000) without concurrent Fibrates and taking
more than one statin: 51
(see: http://www.citizen.org/publications/release.cfm?ID=7051)
From October 1997 to January 2001, nearly 300 million prescriptions were
written for statins. That works out to less than 1 chance in 750,000 of
getting rhabdomyolysis and 1 in 5,747,000, or 0.000017 percent, of dying
from it. The odds of a serious bleed from aspirin can be 1 in 50,000.
L.
Re: New Doubts About Celebrex -- Posted by nobody special on 12-19-04 16:06
"Sharon Hope" wrote in message
news:_c0xd.283105$R05.59244@attbi_s53...
(snipped)
> The only fix for this situation is for the Congress to revise the way the
> FDA is funded. Since Congress made FDA rely nearly entirely on "user
> fees" (i.e., a % of the sales of approved drugs), ...
It's not a percentage of sales. User fees are a flat rate.
> the FDA is in the position of cutting its own budget if it takes a drug
> off the market.
True, if the NDA is withdrawn therefor no user fees would be paid for that
drug.
> An example of this in action is the decision by the FDA to increase the
> Statin market to Diabetics, immediately after 3 studies by Dr. Gaist were
> published showing that statins CAUSE neuropathy. Diabetics have a
> particular succeptibility to neuropathy, but a diabetic population
> consuming statins meant a larger 'take' for the FDA in user fees.
Only if it's a new drug or a new formulation of an existing drug. If it's
merely an additional indication for an existing product, there would be no
increase in user fees other than the initial application fee for the
supplement.
Re: New Doubts About Celebrex -- Posted by Sharon Hope on 12-21-04 18:43
Frightening irony in this scenario:
People at risk for heart attack are prescribed Pfizer drug Lipitor.
Pfizer drug Lipitor causes myopathy and mitochondrial damage (visible on
muscle biopsy), resulting in apoptosis, resulting in high levels of uric
acid (body's way of halting cell death), resulting in gout (arthritis).
People with arthritis are prescribed Pfizer drug Celebrex.
Pfizer drug Celebrex causes increased risk for heart attack.
People at risk for heart attack are prescribed Pfizer drug Lipitor...
In software engineering, they call this an endless loop.
"R.S." wrote in message
news:meg7s0dtvjpqpvpt9q9tpsarv9h6itpaor@4ax.com... > New York Times
> December 18, 2004
>
> EDITORIAL
> New Doubts About Celebrex
>
> Let's hope that Pfizer isn't falling into the same mind-set that Merck
> demonstrated when it stonewalled for years over the safety of its
> popular arthritis drug, Vioxx, only to yank it from the market when a
> convincing study found it raised the risk of cardiovascular problems.
> Yesterday Pfizer announced the results of a government-sponsored
> clinical trial, which showed that its own best-selling arthritis drug,
> Celebrex, more than doubled or tripled the risk of heart attacks,
> strokes and cardiovascular deaths, depending on the dosage.
>
> The company found all sorts of ways to express uncertainty over the
> meaning of these findings, calling them "unexpected" and inconsistent
> with its own similar trial and other data. It pledged immediate steps
> to "fully understand" the results. Yet even before any more data comes
> in, it seems clear that patients and doctors must confront the
> possibility that this overhyped class of drugs, known as COX-2
> inhibitors, may raise the risk of heart problems while offering at
> best only limited benefits for some patients. The Food and Drug
> Administration, notoriously weak in policing drugs already on the
> market, must step in to reduce the dangers.
>
> Vioxx and Celebrex became blockbusters thanks to heavy promotional
> campaigns that propelled sales far beyond reason. The ads typically
> implied that the drugs provided exceptional pain relief, but in truth
> careful clinical trials showed that they were no better in that regard
> than such common pain relievers as Advil, Motrin and Aleve.
>
> The presumed advantage of COX-2 inhibitors was that they might cut the
> rate of gastrointestinal side effects like ulcers and bleeding. But
> the evidence of any benefit is skimpy and seems to be offset by the
> heart risks that have driven Vioxx from the market. Those risks have
> also led to required new label warnings about Bextra, Pfizer's other
> entry in the class, and left Celebrex under a cloud. This is a bizarre
> turn of events for drugs taken by millions of Americans in the belief
> that they were safer and more effective than older painkillers.
>
> Pfizer said it would not pull Celebrex off the shelves, a stance that
> is not surprising given the profits generated by the drug, and the
> widespread belief in the industry that Merck only compounded its legal
> and financial problems by withdrawing Vioxx. But if Vioxx was risky
> enough for Merck to remove from the market, one wonders why Celebrex
> should not be yanked as well.
>
> The best hope for an honest assessment of the risks of Celebrex lies
> with the F.D.A. and its expert advisory committees. The agency has
> been sharply criticized of late for failing to protect the public
> adequately against unsafe drugs, especially after the drugs are
> already on the market. Its own reputation will be on the line as it
> ponders how tough to get about Celebrex in coming days.
>
>
>
>
Re: New Doubts About Celebrex -- Posted by zwalanga@yahoo.com on 12-21-04 19:04
Sharon. There is a pattern emerging with {our} posts... Zee (aka mfg)
http://tinyurl.com/4knnr
~~~~~~~~~~~~~~~~~
Sharon Hope wrote: > Frightening irony in this scenario:
>
> People at risk for heart attack are prescribed Pfizer drug Lipitor.
>
> Pfizer drug Lipitor causes myopathy and mitochondrial damage (visible
on > muscle biopsy), resulting in apoptosis, resulting in high levels of
uric > acid (body's way of halting cell death), resulting in gout
(arthritis). >
> People with arthritis are prescribed Pfizer drug Celebrex.
>
> Pfiz rug Celebrex causes increased risk for heart attack.
>
> People at risk for heart attack are prescribed Pfizer drug Lipitor...
>
>
> In software engineering, they call this an endless loop.
>
>
>
> "R.S." wrote in message
> news:meg7s0dtvjpqpvpt9q9tpsarv9h6itpaor@4ax.com...
> > New York Times
> > December 18, 2004
> >
> > EDITORIAL
> > New Doubts About Celebrex
> >
> > Let's hope that Pfizer isn't falling into the same mind-set that
Merck > > demonstrated when it stonewalled for years over the safety of its
> > popular arthritis drug, Vioxx, only to yank it from the market when
a > > convincing study found it raised the risk of cardiovascular
problems. > > Yesterday Pfizer announced the results of a government-sponsored
> > clinical trial, which showed that its own best-selling arthritis
drug, > > Celebrex, more than doubled or tripled the risk of heart attacks,
> > strokes and cardiovascular deaths, depending on the dosage.
> >
> > The company found all sorts of ways to express uncertainty over the
> > meaning of these findings, calling them "unexpected" and
inconsistent > > with its own similar trial and other data. It pledged immediate
steps > > to "fully understand" the results. Yet even before any more data
comes > > in, it seems clear that patients and doctors must confront the
> > possibility that this overhyped class of drugs, known as COX-2
> > inhibitors, may raise the risk of heart problems while offering at
> > best only limited benefits for some patients. The Food and Drug
> > Administration, notoriously weak in policing drugs already on the
> > market, must step in to reduce the dangers.
> >
> > Vioxx and Celebrex became blockbusters thanks to heavy promotional
> > campaigns that propelled sales far beyond reason. The ads typically
> > implied that the drugs provided exceptional pain relief, but in
truth > > careful clinical trials showed that they were no better in that
regard > > than such common pain relievers as Advil, Motrin and Aleve.
> >
> > The presumed advantage of COX-2 inhibitors was that they might cut
the > > rate of gastrointestinal side effects like ulcers and bleeding. But
> > the evidence of any benefit is skimpy and seems to be offset by the
> > heart risks that have driven Vioxx from the market. Those risks
have > > also led to required new label warnings about Bextra, Pfizer's
other > > entry in the class, and left Celebrex under a cloud. This is a
bizarre > > turn of events for drugs taken by millions of Americans in the
belief > > that they were safer and more effective than older painkillers.
> >
> > Pfizer said it would not pull Celebrex off the shelves, a stance
that > > is not surprising given the profits generated by the drug, and the
> > widespread belief in the industry that Merck only compounded its
legal > > and financial problems by withdrawing Vioxx. But if Vioxx was risky
> > enough for Merck to remove from the market, one wonders why
Celebrex > > should not be yanked as well.
> >
> > The best hope for an honest assessment of the risks of Celebrex
lies > > with the F.D.A. and its expert advisory committees. The agency has
> > been sharply criticized of late for failing to protect the public
> > adequately against unsafe drugs, especially after the drugs are
> > already on the market. Its own reputation will be on the line as it
> > ponders how tough to get about Celebrex in coming days.
> >
> >
> >
> >
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