According to California investigators, this drug combination can help with arthritis pain while warding off gastrointestinal side effects of NSAIDs in people with certain risk factors for gastrointestinal problems like stomach ulcers and heartburn.

The research compared results from arthritis patients who took an NSAID alone, an NSAID plus a heartburn drug known as a proton pump inhibitor, and a Cox-2 inhibitor drug. Cox-2 inhibitors have been prescribed for many arthritis patients because they don’t cause gastrointestinal problems, but the safety of these drugs, including Vioxx (rofecoxib) and Celebrex (celecoxib), has recently been called into question.

The main goal of the study was to determine if the combination treatment would be cost effective when compared to the other two treatments.

The investigation showed NSAIDs alone were probably the best choice for people who didn’t have risk factors for gastrointestinal events. But among people with risk factors -- including those who are over age 65 or who are on blood thinners or steroids -- the combination NSAID plus proton pump inhibitor strategy was more cost effective because it helped avoid costly complications from gastrointestinal disorders. The Cox-2 drugs were more expensive than either the NSAID alone or combination strategy.

The authors call for additional clinical studies to compare both the cost and the effectiveness of these various drug strategies for alleviating arthritis pain in various patient populations.

SOURCE: Arthritis Care & Research, 2005;53:185-197