The arthritis dilemma: When drugs help but also hurt patients

A federal agency sorts through the many options for this common condition but finds, not surprisingly, that all have downsides.

By Susan J. Landers, AMNews staff. Nov. 6, 2006.

Washington -- Relieving arthritis pain is a big deal for patients and physicians, but doing so safely continues to pose problems.

Nonsteroidal anti-inflammatory drugs, including aspirin, present gastrointestinal risks, and the briefly shining stars in the new "coxib" subset of nonsteroidals were soon tarnished when they were found to elevate cardiovascular risk.

The Agency for Healthcare Research and Quality spotted the quandary doctors face and conducted an evidence-based analysis of the risks and benefits of 26 arthritis pain medications available via prescription or over the counter. Although the findings, published Sept. 26, failed to find a magic bullet, they do represent the most comprehensive review to date of the complex world of arthritis pain medication.

Just days after the AHRQ report's release, the Centers for Disease Control and Prevention published new figures that emphasize how large the nation's arthritis problem already is and how it likely will get worse.

In its Oct. 13 Morbidity and Mortality Weekly Report, the CDC revealed that more than 21% of adults, or 46.4 million people, said they had physician-diagnosed arthritis. Of these, more than 8%, or 17.4 million U.S. residents, said arthritis pain causes them to limit some of their activities. As the population ages, arthritis is expected to affect an estimated 67 million adults in the United States by 2030, according to the CDC.

Although the AHRQ report revealed no simple solutions, it did lay out the issues. "These findings represent a vital comparison of medications that are taken by millions of Americans," said AHRQ Director Carolyn M. Clancy, MD, in a statement. "The report also shines a bright light on questions that could further our knowledge and give patients research-based evidence to help them choose the best available treatment."