On Thursday, April 12 an FDA advisory panel will discuss
whether or not to recommend that the FDA approve Merck & Co’s COX-2
inhibitor, Arcoxia (etoricoxib). The drug is manufactured by Merck, the
same company that made Vioxx, which was pulled from the market in the fall of
2004. Merck applied for approval to sell Arcoxia as a treatment for the
signs and symptoms of osteoarthritis .
Currently, the only COX-2 inhibitor remaining on the market
is Celebrex , made by Pfizer, Inc. These COX-2 inhibitors are all types of
NSAIDs. Over the counter types of NSAIDs include naproxen (sold as Aleve)
and ibuprofen. The difference between the prescription COX-2s and the OTC
NSAIDS (and the big selling point) is that the COX-2s have a lower risk of
bleeding ulcers and other GI complications than other NSAIDs. However,
studies have shown that the COX-2s have a higher risk of heart attack and
strokes. Vioxx and Bextra were both subsequently...
Dear Dr. Borigini, My father (72 years old) has Rheumatoid Arthritis in his hand. I would like to know if an artimplant spacer will work for his condition, or if should he try hyalgan before. He had a triple heart bypass about 4 years ago and he has being using Celebrex to control the pain. If your father suffers from rheumatoid arthritis, and his disease is active, then he would probably be a candidate for disease modifying medications—assuming there are no contraindications. Hand surgery for rheumatoid arthritis is a rather common occurrence, but it is usually done to correct deformities in patients whose disease is relatively under control, or to remove stubborn inflammatory tissue around a joint (synovectomy) or tendon to avoid damage to those areas. Hyalgan is used in osteoarthritis ; it is FDA approved for knees, not finger joints. Celebrex is used in both osteoarthritis and rheumatoid arthritis. You mention that your father had heart bypass surgery, and I am sure you are awa...
A couple of months back I wrote a post discussing the concerns I and many others have regarding the return of severe gastrointestinal side effects as a result of the increasing use of the so-called traditional anti-inflammatories. This is of course to be expected due to the fears so many patients have now of the sole COX-2 inhibitor remaining on the market in the United States-- Celebrex . Many of my patients are simply refusing to take Celebrex out of fear it "might kill me." The issue of whether the use of COX-2 inhibitors with low-dose aspirin is reasonable for patients at risk of cardiovascular events raised its weary head once more the last few weeks. This time, a provocative article appeared in the December 22, 2007 issue of the British medical journal "The Lancet." The author, a rheumatologist at Stanford University, feels that COX-2 inhibitors are preferable to traditional anti-inflammatories (such as Motrin and Voltaren ) in p...
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