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More Evidence Found of Painkiller Heart Risks
More Evidence Found of Painkiller Heart Risks -- Posted by Roman Bystrianyk on 01-17-05 15:03
http://www.healthsentinel.com/news.php?event=news_print_list_item&id=550
"More Evidence Found of Painkiller Heart Risks", Reuters UK, January
17, 2005,
Link:
http://www.reuters.co.uk/newsArticle.jhtml?type=healthNews&storyID=7347434
More evidence of how painkillers called COX-2 inhibitors can raise the
risk of heart disease was published Monday, showing Pfizer Inc.'s
Bextra can triple the risk of heart attack and stroke in certain
patients.
A second study shows how older drugs such as aspirin work to prevent
heart disease. Both appear in this week's issue of the American Heart
Association journal Circulation.
The COX-2 inhibitors were designed to help treat arthritis pain and
similar long-term conditions without the serious stomach side-effects
of aspirin and related drugs such as ibuprofen, and other non-steroidal
anti-inflammatory drugs or NSAIDS.
But in September Merck & Co. Inc. pulled its COX-2 inhibitor Vioxx from
the market after clear evidence its use could raise the risk of heart
attacks. And in December, the National Institutes of Health halted a
study involving Pfizer's COX-2 inhibitor Celebrex.
The U.S. Food and Drug Administration cautioned patients and doctors to
limit their use of such drugs and will hold a meeting next month to
discuss them. The European Medicines Agency is holding a similar
meeting this week.
Dr. Garret FitzGerald of the University of Pennsylvania School of
Medicine and colleagues used a statistical approach called
meta-analysis to combine the findings of two trials to estimate the
risk of heart attack and stroke in people taking Bextra, another COX-2
inhibitor made by Pfizer.
Their analysis, first presented at a Heart Association meeting last
November and published this week in Circulation, suggests Bextra
tripled the combined incidence of heart attack and stroke in heart
bypass surgery patients.
NSAIDS work by suppressing two enzymes called COX-1 and COX-2. But they
can cause gastrointestinal bleeding, and research had suggested that
suppressing COX-1 caused this damage.
So drug companies worked to make drugs that only affect COX-2, the
enzyme associated with pain and inflammation.
But in the second study, the researchers studied mice genetically prone
to hardening of the arteries or atherosclerosis and found that a
compound called thromboxane or TxA2, produced by COX-1, accelerates
atherosclerosis.
"This is of particular interest, as low-dose aspirin prevents heart
attack and stroke by blocking COX-1 formation of TxA2 in blood cells
called platelets," FitzGerald said in a statement.
When a COX-2 inhibitor was added, something happened that may help
explain why the COX-2 inhibitors raise the risk of a heart attack, said
FitzGerald's colleague, Karine Egan.
"Addition of the COX-2 inhibitor caused changes that, if they occurred
in humans, would result in a loss of stability of the plaque, making it
more likely to rupture and activate clotting, causing heart attack or
stroke," she said.
"These results would have disturbing implications for patients at high
cardiovascular risk treated with aspirin and a coxib (COX-2
inhibitor)," FitzGerald said.
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