Arthritis drugs: The arthritis drugs that can increase heart attack risk

Im going to ask you to imagine something so far fetched that youll think Ive lost my marbles.

Glucosamine is an effective natural therapy used to relieve arthritis pain. Now lets imagine that a researcher from a mainstream medical authority examined nearly one and a half million medical records and found that 27,000 heart attacks and sudden cardiac deaths could have been avoided if patients had not been using glucosamine.

Now lets imagine that the mainstream medical authority responded to this and other negative studies about glucosamine by convening an expert panel to review the evidence regarding glucosamines safety.  Well its a foregone conclusion surely? All those thousands of heart attacks?  Say goodbye to glucosamine!

But wait.  Lets imagine that the panel comes back with a recommendation that glucosamine can remain on the market, but products containing glucosamine should carry a warning, and manufacturers of the pain killer should not be allowed to advertise their products unless the mainstream medical authority wrote the advertisements.

I bet I lost you right at the end there. I admit, I pushed it way beyond the limits of credibility. Would the medical authority allow the continued sale of a natural product that was known to cause thousands of heart attacks? Not on your life.

But if that product was a class of drugs that brought in billions of dollars of revenue every year - well! - then everything would be different!
Credibility? Thats a small price to pay to keep those billions rolling in.

Safe enough?

A similar situation currently exists in the US.

Recently the confusion over the use of Vioxx, Celebrex, Bextra and other pain-killing drugs got even more confusing in the US when a Food and Drug Administration panel advised the agency to keep the drugs on the market. So the verdict is that the drugs are safe, right? Well, not exactly. Theyre safe enough to sell, says the panel, but should carry a strict warning on the packaging.

Many arthritis patients find this class of drugs (COX-2 inhibitors) to be very effective. But theres just that one nagging problem: Their use has been shown to sharply increase heart attack risk.

After the panels decision was announced the chairman of the panel, Dr Alastair Wood, told The New York Times: It would be a brave man or woman who started a patient with a clear history of heart disease on these drugs.

Brave? Maybe brave is FDA slang for idiotic.

Brave new world

Heres my favourite part of the panels recommendations: The US Times noted that most of the panellists were adamant that these drugs should not be advertised unless the FDA or an independent group writes the advertisements.

Amazing. You have to wonder if they really thought that one through. Theyre actually suggesting that someone at the FDA should write advertising copy to promote the sale of a drug thats been shown to significantly increase heart attack risk. Thats like asking a judge to make the closing argument for a defendant in a murder trial.

Executives at Merck pulled Vioxx off the UK market last September voluntarily when a new study once again demonstrated that the heart attack risk associated with the drug was unacceptable. But now that the FDA panel has decreed that the risk for these drugs IS acceptable, the folks at Merck say that they may put Vioxx back on the market in the US.

This is playground logic at its most basic: If THEYRE getting away with it, why shouldnt WE?

The FDA usually rubber stamps the results of advisory panels. In the upcoming days or weeks well find out if the FDA really believes that a few thousand heart attacks here or there is an acceptable exchange for keeping the cash cows milking.

Lets hope that the UK medical authorities dont follow suit.