HEALTH & SCIENCE

Final word still out on popular pain medications

Independent studies that sort through the risks posed by COX-2 inhibitors and the older NSAIDS are needed, physicians say.

By Susan J. Landers, AMNews staff. Jan. 31, 2005.

Washington -- Is the bottom line in sight for physicians and patients puzzling over recent news about COX-2 inhibitors, NSAIDS and the risks they carry?

Not yet. And one may be a long time in coming. But perhaps the risk versus benefit calculation is becoming a bit clearer.

News of the withdrawal of the COX-2 inhibitor Vioxx because of cardiovascular risks was quickly followed by findings that cast doubt on other drugs prescribed for and taken by millions for long-term, non-narcotic pain relief, often for arthritis.

As they have in the recent past, physicians once again were fielding queries from dozens of nervous patients who wondered if they should stop taking the popular drugs. Placed under a cloud of suspicion were Celebrex, Bextra, and the older nonsteroidal anti-inflammatory drug, Aleve, or naproxen.

"I think it's going to take a long time to settle down," said Mary Frank, MD, president of the American Academy of Family Physicians, of the ensuing controversy. "Some of the unsettled environment has to do at this point with a rising awareness that no medication is absolutely safe and no new medication has been studied for very long."

There has also been some "jump-the-gun" thinking going on, said Dr. Frank. Although preliminary results of a trial on naproxen, which was approved for over-the-counter sales a decade ago, showed a possible increased risk of heart attacks among participants in an Alzheimer's disease study, some physicians believe the risk to be small.

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