Celebrate. Celebrate. Physicians are delighted with a Food and Drug Administration (FDA) advisory panel’s recommendation earlier this year that Vioxx and its cousins Bextra and Celebrex (all medicines known as Cox-2 inhibitors) should remain on the market, despite evidence they increase heart disease risk in some people. The panelists reached their decision after weighing all the data and concluding the benefits of these pain-relieving drugs outweighed the risks.
Specifically, these scientists acknowledged that, for some patients, these prescription drugs were uniquely effective in reducing pain from arthritis and other causes. For others—concerned about ulcers associated with aspirin and other OTC analgesics—the Cox-2 inhibitors offered the advantage of minimizing potentially serious effects of stomach irritation.
Now is an appropriate time for everyone to take a fresh look at the benefit-risk equation for Vioxx and the other Cox-2 inhibitors.
The risks-increased risk of heart disease in some who use the drugs—have been well publicized. Much less publicity has been given to a spectrum of real and potential benefits that go way beyond reduced risk of stomach irritation. These little-discussed benefits would have been lost, perhaps permanently-had Vioxx, Bextra and Celebrex been driven from shelves in pursuit of perfect safety, an unattainable goal.
For example, there is substantial evidence Cox-2 inhibitors can reduce development of colon polyps, which may become colon canceL Indeed. Celebrex is FDA-approved for those genetically prone to colon cancer. Ironically, the 2004 study that revealed the elevated heart attack risk of Vioxx was primarily designed to further establish the drug’s effectiveness in protecting against colon cancer. And while the results of that interrupted trial have not yet been published, there is good reason to believe they will confirm the protective effects against colon cancer established in research over the last 10 years.
At the time of its withdrawal from the market last fall, studies of Vioxx as well as the other Cox-2 drugs suggest that they had other anti-cancer properties as well, possibly reducing the risk of malignancies of a number of sites, including the lung and esophagus.
Had these drugs been dismissed, their untapped promise for prevention would have evaporated well before it was evaluated and applied to save lives. Fortunately, cooler and wiser heads prevailed.
The FDA advisory panel recommends that Cox-2 inhibitors should be ______.
A．given clinic test
B．taken with great caution
C．used to treat heart problems
D．made available to the patients