-- Alan Mozes
WEDNESDAY, May 2 (HealthDay News) -- New research has uncovered
how some cox-2 painkillers increase the risk for both heart attacks
The once popular cox-2 drugs, Vioxx and Bextra, were pulled off
the market in 2004 and 2005, respectively, after research showed
that both raised the chances of cardiovascular trouble. Meanwhile,
Celebrex, a painkiller in the same drug class that remains on the
market, carries a "black box" warning alerting patients to
potential heart risks.
Now, a team of scientists from the University of Pennsylvania in
Philadelphia say that, although cox-2 inhibitors are very good at
inhibiting the workings of the cox-2 enzyme -- and thereby easing
pain -- they also throw off the cardiovascular system's delicate
balance by inhibiting an enzyme that relaxes blood vessels and
guards against clotting.
"It's really about a rock and a hard place," said Dr. Christopher Cannon, a cardiologist at Brigham and Women's Hospital in Boston. "There's a balance in the bloodstream of clotting and vasoconstriction, as well as protection against clotting and vasodilation, which means that there's a constant balance of clotting and preventing clotting, and constricting arteries and dilating arteries."
"But with cox-2 inhibitors, they have found that you knock the protective side of that balance off," Cannon said. "And then you're left only with the constrictive part, which means the drugs up the risk for clotting and arterial constriction."
"This problem is bigger than just Vioxx, which no longer exists," he added. "It applies to every single NSAID (non-steroidal anti-inflammatory drug), because with all NSAIDs -- including Celebrex and ibuprofen, which zillions of people take -- the same issue exists. You block out the good stuff and leave the bad stuff unchecked. The one exception is Naproxen, which has an anti-platelet effect that seems to work against stroke and heart attack risk."
"Sometimes you have to take a cox-2 because you have really bad daily pain," said Cannon. "But this is a dose-dependent problem, with the more cox-2 you take the greater the cardiovascular risk. So you have to limit the dose and take the least amount you can get away with, so you can try to control crippling pain but also try not to poison your blood vessels and predispose yourself to clotting and high blood pressure."
The latest research was led by Dr. Garret FitzGerald, chairman
of Penn's department of pharmacology and director of the Institute
for Translational Medicine and Therapeutics. He and his colleagues
published their findings in the May 2 issue of the journal
Science Translational Medicine and the April 9 online issue
Proceedings of the National Academy of Sciences.
Find out more about NSAIDs at the
American Academy of Orthopaedic Surgeons.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Publishing. All rights reserved.