Arthritis Pain Relief Update (cont.)

KLIPPEL:
This is an interesting problem, because the reason Celebrex or any Cox-2 inhibitor is used is to reduce the risk of GI side effects. If one adds aspirin in any dose, even low doses to protect your heart, a person will increase his risk of GI side effects. One needs to be particularly cautious about combining NSAIDs, including aspirin, and remind people to make sure their doctors are aware of all medications, including over-the-counter meds that are being taken.

MEMBER QUESTION:
Will Vioxx be making a return to the market or will it disappear forever?

KLIPPEL:
We're actually encouraged by the consideration of Merck to put Vioxx back on the market, for two reasons. One is there are many people who very much relied on Vioxx for pain relief and for those people in particular they would be benefited by this decision. The second opportunity this presents is to have Merck take a leadership role in helping to educate the consumer about the benefits and risks of this classification of medicines. We look upon this decision with interest and certainly it would be in patients' best interests if a decision was made to return the medication to the marketplace.

MEMBER QUESTION:
Dr. Klippel, I currently still take Celebrex and without it, after seven calendar days, I am completely bedridden. I feel that its benefits of enhancing my life far outweigh the risk. Do you know if they are seriously considering how this medication greatly affects others' overall well-being either way?

KLIPPEL:
I think we should applaud the decision of Pfizer when the controversy began to keep Celebrex on the market and it was done specifically for people like this questioner, who were benefiting from this drug. We would applaud the decision of the FDA Advisory Committee who has made a decision to the FDA to keep both Celebrex and Bextra on the market.

"I think it's incumbent on all of us, the drug companies, federal regulatory agencies, as well as the Arthritis Foundation to learn from the recent experience with Cox-2s, so that we all do a better job of informing the consumer in a responsible manner and not creating either confusion or panic."

MEMBER QUESTION:
Thank you for your time doctor. A lot has been made not only of Celebrex and fellow Cox-2 inhibitors, but also Naproxen. I am a 27-year-old and suffer from PA and have been on Naproxen 500mg tabs for over 10 years. What are you thoughts about the future of Naproxen?

MEMBER QUESTION:
Were the concerns about Aleve put to rest, or do we need to be concerned?

MODERATOR:
(Naproxen = Aleve)

KLIPPEL:
Naproxen would be an example of an over-the-counter medication in which we have known about the efficacy of this drug for more than a decade. In our opinion, this continues to be a very effective and safe choice of NSAIDs. We believe the public was unduly alarmed by expressing a concern that the FDA Advisory Committee considered and we, again, applaud the FDA's Advisory Committee's decision that this is a safe an effective form of NSAID.

MEMBER QUESTION:
Do you think the pharmaceutical companies have handled the release of this information in the proper way or could they be doing a better job for the consumer?

KLIPPEL:
I think it's incumbent on all of us, the drug companies, federal regulatory agencies, as well as the Arthritis Foundation to learn from the recent experience with Cox-2s, so that we all do a better job of informing the consumer in a responsible manner and not creating either confusion or panic.

What we believe is that there's very little attention paid to why people use drugs in the first place, which is benefits, and I think we're fortunate in this country to have pharmaceutical and biotechnology companies that each year produce more effective and safer medications for the person with arthritis. These are responsible companies that are contributing to improving the lives of people with arthritis.

MODERATOR:
So the best way to protect yourself is to be an informed consumer -- ask your doctor all of the questions you have. Be a partner in your own care.

MODERATOR:
Let's move away from the drugs for a moment and go back to two things you mentioned earlier -- diet and fitness. Do you have specific recommendations for exercise to help arthritis sufferers?

KLIPPEL:
The exercise needs to be individualized, based on the joint or joints affected by arthritis. For example, a person with arthritis affecting the knee would be doing a different set of exercises than a person with arthritis of the lower back. There are certainly many good resources for advice on exercise. In particular, the Arthritis Foundation web site, arthritis.org or brochures or books from the Arthritis Foundation can be very helpful in recommending exercises.

For most people, walking would be a great form of exercise which not only is good for joints, but it is good for their general fitness and for their heart. The Arthritis Foundation in April and May has an Arthritis Walk across the country that we would encourage everyone to participate in.