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Arthritis Drug Easy on the Stomach, Study Confirms

By
WebMD Health News
Reviewed by Aman Shah, MD

Sept. 12, 2000 -- The new arthritis drug Celebrex causes significantly fewer stomach problems than older treatments, according to a large study. But aspirin -- even at low doses -- largely takes away this benefit.

 

Celebrex and Vioxx are the two FDA-approved arthritis drugs called "COX2 inhibitors." They are not more potent than ibuprofen and other anti-inflammatory arthritis drugs, but they have a more specific target in the body. This is supposed to make the drugs much less likely to cause stomach problems and ulcers -- a major problem for as many as one in five people who take anti-inflammatory drugs every day. There also were worries that the new drugs would be at least as hard on the kidneys as the old drugs. Now a report in the Journal of the American Medical Association shows that at least one of the new arthritis drugs is significantly safer than the older ones.

 

"There is now a good, new alternative for the treatment of arthritis," study supervisor James B. Lefkowith, MD, tells WebMD. "Patients have to take these medicines for many years, and they need to know they can take it with safety over a long period of time. This trial now gives data that this option can work." Lefkowith is global director of Celebrex research for Pharmacia, the drug's manufacturer and sponsor of the study.

 

The study enrolled some 8,000 patients with rheumatoid arthritis or osteoarthritis. Study participants did not know whether they were taking Celebrex, ibuprofen, or Voltaren, another NSAID. In order to test the drug's safety, patients who received Celebrex got a much higher dose than normally would be prescribed. After six months, there were significantly fewer side effects among patients who got Celebrex than among those who got the NSAIDs.

 

Because they wanted to test the drug under realistic conditions, the researchers who designed the study allowed patients to take low-dose aspirin (325 mg) to prevent heart disease. Aspirin is an NSAID, but at such a low dose it was not supposed to cause damage. But that's not what the researchers found -- patients who took aspirin along with Celebrex had nearly as many stomach problems and ulcers as patients who took NSAIDs.

 

"This is a very interesting study -- this effect for aspirin was never seen before," study co-author Lee Stuart Simon, MD, tells WebMD. "The reality is that aspirin even at a low dose has the same effect as full-dose NSAIDs. It makes us wonder what we are doing with aspirin. ... I guess what we have learned is that aspirin is a pretty dangerous drug for the stomach. You have to weigh its potential for reduction of heart disease with the risk of gastrointestinal bleeding." Simon, an associate professor at Harvard Medical School, is director of rheumatology clinical research at Beth Israel Deaconess Hospital in Boston.

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