Do Two Popular Arthritis Drugs Increase Heart Attack Risk?
In the current study, Nissen and his colleagues compared Vioxx to the traditional arthritis drug naproxen, which works in a way similar to aspirin. People on Vioxx were twice as likely to have a heart attack than patients on naproxen, says Nissen. But among the 8,000 people in the study, only 161 patients had heart attacks and 70% of them were taking Vioxx.
The second study compared Celebrex with ibuprofen and diclofenac, an older arthritis medicine sold under the names Voltaren and Cataflam. The scientists did not find that people on Celebrex were more likely to have a heart attack. However, the people in the study were allowed to take aspirin, which is known to protect against heart attacks. This made the results harder to interpret.
Nissen then compared Vioxx and Celebrex users to placebo groups in four large studies. Again, the researchers found that the people on the Cox-2 inhibitors were more likely to have a heart attack than people taking placebo, says Nissen.
Valentin Fuster, MD, former president of the American Heart Association, tells WebMD that this study was done to test the side effects of these drugs on the stomach and intestines and not to look at the drugs' effects on the heart. So experts really can't say for sure that these drugs really have any bad effects on the heart based on this study, he says.
But even though the study "is not perfect, the findings cannot be thrown into the wastebasket," says Fuster. Because so many people use the drugs -- more than 2 million prescriptions will be written this year -- he warned, "we had better pay attention to this observation."
Fuster adds that the drugs have made a huge impact on people's lives, often allowing them to become much more active after years of living with painful arthritis. And he says that among his patients, he is already using the drugs with caution because they can cause swelling and increase blood pressure in some people.