Thursday, December 23, 2004

Anti-Inflammatory Drugs

Here's an article by Steve Milloy at Fox News with some hopeful news for those who find the quality of their lives much improved by anti-inflammatory drugs but who are concerned about recent reports of increased incidence of heart attack and stroke among those who use them:

The questions recently raised about whether Vioxx, Celebrex, Aleve and other anti-inflammatory medications pose some small heart attack or stroke risk to certain individuals should be answered as soon as possible.

In the meantime, however, it would seem that the great weight of data - gathered over years and even decades - evidencing the undisputed benefits and general safety of these drugs should have prevented any panic caused by the relative novelty, paucity and inconclusive nature of the data underlying the ongoing scare.

The clinical trials triggering the controversy are contradicted by many other studies which haven't reported any increased risk of heart attack and stroke; nor are the trials particularly impressive from a statistical viewpoint. The reported correlations are small and may, in fact, be artifacts caused by inappropriate study design.

None of the clinical trials giving rise to the questions about Vioxx, Celebrex and Aleve were, after all, specifically designed to test whether the drugs posed a heart attack or stroke risk. The data on Vioxx came from a study of gastrointestinal effects; the Celebrex data came from a cancer prevention study; and the Alleve data came from an Alzheimer's prevention study.

If weak statistical correlations are to raise legitimate concerns about drugs that have been widely used for years without noticeable problems, those correlations should at least be produced by studies specifically designed to examine the precise health endpoints of concern. Results from well-designed studies would allow physicians and arthritis sufferers to choose whether to manage any clearly identified risks of effective drugs, rather than be told to be happy with "safe", but ineffective treatments such as acupuncture.

Those who have not yet reached the stage in life where arthritis makes even the simplest tasks a painful endurance test may find it hard to imagine how much of a difference these drugs can make in one's life. Let's hope that further tests show their risks to be minimal.