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