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Old-Fashioned Drug Trumps New Arthritis Pills

Posting Date: 01/10/2005

First it was Vioxx. Then Bextra and Celebrex were tarnished. Even the over-the-counter arthritis drug Aleve (naproxen) has been linked to cardiovascular complications.

Several weeks ago a safety expert for the FDA estimated that as many as 160,000 Americans may have suffered a heart attack or a stroke as a side effect of Vioxx. With Bextra and Celebrex added to the list, goodness knows how many drug-induced heart attacks may have occurred.

Ironically, these pricey prescriptions (more than $3 a pill) were supposed to be safer than old-fashioned arthritis medicines. We?re now learning that the hype was way out of line.

The oldest arthritis medicine, aspirin, may turn out to be the unsung hero after all. At just pennies per pill, aspirin remains the best deal in the pharmacy. No other arthritis drug has ever been shown to be superior to aspirin for relieving pain or inflammation.

Aspirin has an added benefit. Unlike the medicines now under scrutiny, aspirin actually lowers the risk for heart attacks and thrombotic (clotting) strokes. Dozens of studies involving thousands of subjects over several decades have concluded that aspirin is a life saver.

In one of the largest studies of its kind, the Physicians? Health Study followed 22,000 men for many years. Aspirin lowered the risk of a heart attack by 44 percent in healthy men. Those at high risk for heart disease doubled their benefit. The results were so good the investigators stopped the study early because they felt it would be unethical to deprive the physicians on placebo of the benefits of aspirin.

In contrast, the Vioxx and Celebrex studies were halted prematurely because the results were so alarming. People on the medications developed a significantly higher risk of heart attack.

Aspirin can even reduce the risk of complications from coronary artery bypass surgery. In one study, (New England Journal of Medicine, Oct. 24, 2002) post-surgical strokes, heart attacks, kidney problems and intestinal damage were much less common than expected in the patients on low-dose aspirin. Aspirin can cause bleeding, but even this side effect was less common than anticipated.




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