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Pain Management Health Center

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Cox-2 Use Is Down, but Ulcers Are Up

Patients Turn to Traditional NSAID Painkillers but Skip Drugs That Protect Their Stomachs

Increase in Ulcers in 2005 continued...

The Cox-2 drug Vioxx was pulled from the market in September 2004 by its manufacturer. The FDA called for the withdrawal of a second Cox-2 drug, Bextra, in 2005.

There was a corresponding 21% increase in serious GI complications in 2005, the study found.

"Gastrointestinal bleeds are still an important side effect, and we need to be aware of this because we took our eyes off the ball and look what happened," Singh tells WebMD.

In 2004, just 14% of patients were not receiving gastroprotection. By contrast, 79% of patients were not receiving gastroprotection in 1997, the study shows. This decline coincided with the eradication of H. pylori infection as a major cause of ulcers as well as better medical care including the growing use of Cox-2 inhibitors.

"It started getting smaller and as Cox-2 inhibitors were introduced, the gap became even smaller," Singh says.

In fact, the rate of serious GI complications dropped from 682 per 100,000 prescriptions in 1997 to 357 per 100,000 in 2004. The sharpest decline occurred from 1999 to 2000. There were 570 GI complications per 100,000 prescriptions in 1999 and 423 GI complications per 100,000 prescriptions in 2000.

This drop corresponded with a large decline in the gastroprotection gap from 55.6% in 1999 to 25.2% in 2000, the study showed.

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