Study: No Long-Lasting Vioxx Heart Risk
Risk Goes Away When Vioxx Use Stops; Low-Dose Celebrex Seems Safe
How Safe Is High-Dose Celebrex? continued...
A close look at the findings does not give Celebrex a totally clean bill of
health, says rheumatologist Axel Finckh, MD, a researcher at Brigham and
Women's Hospital in Boston, who has studied Cox-2 inhibitors.
Finckh suggests that the findings provide added evidence that it is Cox-2
inhibition -- and not some other effect -- that underlies Vioxx's heart
toxicity. Celebrex, too, is a Cox-2 inhibitor, although it is not nearly as
potent as Vioxx in this regard.
"Very few of the Canadian patients took more than 200 milligrams per day
of Celebrex -- and in clinical trials, the only heart risk was seen in those
taking 400-800 milligrams per day," Finckh notes. "From this study we
can see that lower doses of Celebrex seem to be relatively safe. I don't think
we can say anything about higher doses of Celebrex."
And while Brophy's study shows that aspirin can remedy the heart toxicity of
Cox-2 inhibitors, Finckh says this makes little clinical sense. Patients who do
not suffer stomach and intestinal side effects from aspirin might as well take
the equally effective and less-costly traditional NSAIDs.
"It abolishes the gastrointestinal security of the Cox-2 drugs to take
aspirin," Finckh says. "If you need aspirin for heart protection, you
might as well take a traditional NSAID for pain relief."