Word: coxing
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Scientists are still debating whether that is the case. When the FDA approved the COX-2 inhibitors, it required Merck, the manufacturer of Vioxx, and Pharmacia, which markets Celebrex jointly with Pfizer, to include warnings about potential gastrointestinal problems...
...When the COX-2 inhibitors hit the market in 1999, doctors and patients alike expected a lot from the little painkillers. The old standbys--which include aspirin and ibuprofen (Advil)--can tear up the lining of the stomach and cause serious bleeding disorders. These side effects occur when a protective enzyme called cyclo-oxygenase 1, or COX-1, is suppressed. Because the COX-2 inhibitors don't affect COX-1, it was expected that they would have fewer side effects...
...doctors combined the data from several studies about COX-2 inhibitors in a statistical process called meta-analysis. Then they looked to see if the information could tell them anything about heart-attack risk--something that the original trials had not been designed to explore. Such after-the-fact, or retrospective, analysis falls pretty low on the scale of scientific reliability. But sometimes it provides good clues about where problem areas...
...meta-analysis, published in last week's Journal of the American Medical Association, showed that those who took COX-2 inhibitors suffered slightly more heart attacks than those who took older, aspirin-like drugs. The authors considered several explanations. Since the older drugs help prevent heart disease, the JAMA study might only be picking up the absence of a protective effect in the COX-2 inhibitors. Or the new painkillers might actually promote the creation of blood clots. Or both processes might be at work. The point, Topol says, is that "the cardiovascular effects of the [COX-2 inhibitors...
...where does that leave the patient or doctor? For now, it's best to focus on what's known. If you already have heart disease, make sure it gets treated--whether or not you're taking a COX-2 inhibitor. If your blood pressure creeps up, which sometimes happens with Celebrex and Vioxx, make sure your doctor knows about...