Osteoarthritis - 2001 National Meeting Reports (cont.)

Valdecoxib was shown to be beneficial in treating osteoarthritis of the hip. 

Dr. Shiel's Perspective: This drug may be an additional Cox-2 on the menu in the near future.

ETORICOXIB

Etoricoxib is another Cox-2 NSAID that is being investigated for the treatment of rheumatoid arthritis and osteoarthritis (see Valdecoxib above). Previous studies have demonstrated its effectiveness in relieving the signs and symptoms of joint inflammation.

This experimental drug was shown to be effective in the treatment of osteoarthritis of the knee and hip in over 200 patients. 

Dr. Shiel's Perspective: The drug also may be an additional Cox-2 on the menu in the near future.

Fewer patients treated with etoricoxib had to discontinue the medication because of gastrointestinal complications as compared with the traditional NSAIDs, Voltaren, and Naprosyn. 

Dr. Shiel's Perspective: This is an example of a safety study that must be performed before a drug is approved to demonstrate its value. Because it is billed as a Cox-2 inhibitor, etoricoxib should, and apparently does, have advantages with regard to the stomach and intestines.

Complementary and alternative medicines (CAM) are being used by 33% of osteoarthritis patients. It was also shown that these patients seem to be more cautious about their health, seeking specialists' care more commonly. 

Dr. Shiel's Perspective: As a practicing rheumatologist for two decades, this is not really news. I frankly believe that this study grossly underestimates the number of persons using CAM. It does, however, highlight the need for doctor-patient communication with regard to all manners of treatment.

GLUCOSAMINE

Glucosamine (a radioactive form that could be identified in tissues) taken by mouth was found to be incorporated into the cartilage of Beagle dogs. 

Dr. Shiel's Perspective: This study implies that glucosamine supplements taken by mouth actually can become bioavailable to the cartilage of the joints. Perhaps this will be shown to not only provide some relief of symptoms (already reported in some patients), but it may also be shown in future studies to protect the osteoarthritis joints (being looked into at the NIH).

Drug Complications

September 30, 2004 the Food and Drug Administration (FDA) today acknowledged the voluntary withdrawal from the market of Vioxx (chemical name rofecoxib), a nonsteroidal antiinflammatory drug (NSAID) manufactured by Merck & Co. FDA today also issued a Public Health Advisory to inform patients of this action and to advise them to consult with a physician about alternative medications.

Merck withdrew Vioxx from the market after the data safety monitoring board overseeing a long-term study of the drug recommended that the study be halted because of an increased risk of serious cardiovascular events, including heart attacks and strokes, among study patients taking Vioxx compared to patients receiving placebo. The study was being done in patients at risk of developing recurrent colon polyps.