Vioxx, Celebrex Were Widely Over prescribed
Drug Benefit Trends. 2005; 17 (2): 56. ©2005 Cliggott Publishing, Division of CMP Healthcare Media
Report by Medscape from WebMD,
When COX-2 inhibitors were first introduced in 1999, they were promoted as pain relievers,
inflammation reducers, and less likely than NSAIDs to cause adverse GI effects. Over the next few years, after being heavily
promoted to physicians and the general public, Vioxx and Celebrex became widely used by millions of persons who had little
risk of GI bleeding.
The overuse of the COX-2 inhibitors is documented in a study by researchers from the University
of Chicago and Stanford University School of Medicine; results were published in the January 24 issue of the Archives of Internal
Medicine. Findings of the study, led by Carolanne Dai, MSc, University of Chicago, showed that almost two thirds of the growth
in COX-2 inhibitor use from 1999 to 2002 occurred in patients at minimal risk for GI bleeding from NSAIDs.
Researchers looked at data from 2 nationally representative surveys that tracked patient
visits to their physicians between 1999 and 2002 and the types of medications prescribed at those visits. The researchers
also categorized patients according to their risk of GI bleeding from NSAIDs.
Dai and colleagues found that 73% of patients had either a very low (31%) or low (42%)
risk of GI bleeding from NSAIDs and, thus, no pressing medical reason for them to switch to COX-2 inhibitors. However, this
was the group in which the greatest growth in COX-2 use occurred. The number of physician visits associated with COX-2 use
in these patients increased from 9.5 million in 1999 to 20.9 million in 2002, accounting for 63% of growth in the use of COX-2
inhibitors during that time. Patients most likely to benefit from use of these newer agents—those with moderate or high
risk of GI bleeding—accounted for the remaining 37% increase.
One can only conclude that people in the highest place knew that the action of
the COX-2 inhibitors as to cardiac events took about 2 years before clear evidence of risk became present. For one thing, how is it possible that with 40 studies funded by NIH this wasn’t discovered. (“The NIH, which sponsors over 40 studies using celecoxib for
the prevention and treatment of cancer, dementia, and other diseases, will conduct a full review of all supported studies
involving this drug class.” (Medscape, December 22, 04, “The Pulse of Current Cadiovascular Concern: Anti-inflammatory Medications”). The answer is obvious
instead of using tax money to monitor the safety of drugs, NIH was using it to find new revenues for their makers. The fault lies with our elected officials who place serving the pharmaceutical industry before protecting