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Choosing the Right Arthritis
Medication
Reported November 14, 2006
(Ivanhoe Newswire) -- There are different drug choices
for pain available for arthritis patients, but which one is right for which
patient?
A new study compares two types of painkillers and reveals they have similar
risks, but different side effects. The results of this study could help
doctors determine the best treatment for each patient, according to study
authors.
The research focused on the COX-2 inhibitor etoricoxib and the non-steroidal
anti-inflammatory drug (NSAID) diclofenac. NSAIDS include drugs like Advil
and Aleve. COX-2 inhibitors are drugs like Bextra and Celebrex. Previous
studies have indicated that NSAIDs taken long term can cause
gastrointestinal (GI) bleeding and an increased cardiovascular risk. The
previous research has also indicated COX-2 inhibitors increase
cardiovascular risk, but reduce GI bleeding. Makers of the COX-2 inhibitor
Vioxx pulled the drug from shelves after studies linked it to increased risk
of cardiovascular problems.
The new study included 34,701 patients who were randomly treated with one of
two doses of etoricoxib or diclofenac for 18 months. Researchers from
Brigham and Women's Hospital in Boston led the study.
Researchers report both drugs were effective at treating pain, and the rate
of cardiovascular problems was similar in both groups of patients. They also
found patients on etoricoxib had fewer upper GI problems, but the rate of
life-threatening GI problems was the same for both groups. They say the
patients on the higher dose of etoricoxib had more congestive heart failure,
though this side effect was rare overall. Patients on etoricoxib also had
more swelling of the ankles. On the other side, patients on diclofenac were
more likely to have high blood pressure and more likely to stop using it
because of adverse GI and liver events.
Study authors hope this large, randomized clinical trial will help develop
guidelines for these drugs to help doctors better treat patients.
SOURCE: The Lancet, published online Nov. 13, 2006
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