Arthritis Health Center

Study: No Long-Lasting Vioxx Heart Risk

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."