HYPE OVER PAINKILLERS HURTS PATIENTS

January 5, 2005

Recent scare stories over Vioxx, Celebrex and Aleve (naproxen), have failed to put real risk into perspective, creating confusion and concern among patients. But many doctors would like to allow their patients a choice based on patients' individual needs and risks.

Media stories have neglected the concept of "relative risk," which may involve very little risk at all. For example:

  • The decision to pull Vioxx is based on a study indicating that the baseline risk for heart attack or stroke among patients taking Vioxx is a mere 1.5 percent (15 events per 1,000 people), compared to less than one percent (7.5 events per 1,000) for patients taking a placebo.
  • Both Vioxx and Celebrex are proven to be gentler on the stomach, and are particularly beneficial for patients who are risk for bleeding ulcers, which result in an estimated 15,000 or more deaths per year.
  • Another study indicated that patients taking Aleve experienced a 50 percent increase in cardiovascular events, but the actual numbers are based on a sample of 2,500 patients all over 70 years old; 70 of them experienced such events, with 23 resulting in death.

John Breitner, a lead researcher in the Aleve study, noted that the result of the study was not "statistically significant."

Furthermore, the studies concentrate on the older adult population, but about 250,000 children in the United States suffer from juvenile rheumatoid arthritis and benefit from these medications.

While some physicians and patients will no longer utilize Cox-2 inhibitors (Celebrex and Bextra), many physicians are willing to prescribe them based on an individual patient's age and cardiac risk. In many cases, the benefits to patients who suffer arthritis outweigh the risks.

Sources: Editorial, "The Painkiller Panic;" Thomas M. Burton and Kevin Helliker, "Drug Risk Can Pale Next to Pain;" Antonio Regalado and Ron Winslow, "Some Scientists Say Aleve's Dangers May be Overblown;" all Wall Street Journal, December 23, 2004.

For WSJ texts (subscription required):

http://online.wsj.com/article/0,,SB110376289462107904,00.html?mod=todays_us_opinion

http://online.wsj.com/article/0,,SB110376102922507821,00.html?mod=todays_us_personal_journal

http://online.wsj.com/article/0,,SB110376051134907791,00.html?mod=todays_us_marketplace

 

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