Osteoarthritis Post #11

Non-steroid inflammatory drugs (NSAIDS)

Aspirin, the first non-steroidal anti-inflammatory, was first developed in 1899 from the bark of a willow tree.  It was brought to the market by the company later known as F. Bayer & Co in 1925.  Beginning in the 1970s many other NSAID drugs were developed and marketed for their pain relief, fever reduction, and anti-inflammatory properties.  NSAIDS work by blocking an enzyme (cyclo-oxygenase or COX) which decreases the body’s ability to make inflammatory proteins called prostaglandins.  With decreased inflammation, less pain occurs.  Our bodies make at least two COX enzymes. The early NSAIDS blocked both, one of which protected the stomach lining.  That explains why the early NSAIDS caused more stomach distress and GI symptoms. 

Researchers developed the COX-2 NSAIDS which relieved arthritis pain and caused less GI symptoms.  When the first COX-2 drug was marketed, it became hugely popular with arthritis sufferers who found life better because they experienced less pain and less GI symptoms.  Over 91 million prescriptions of refecoxib (Vioxx) were written in the 5 years between 1999 and 2004 when the manufacturer pulled the drug from the market.  Some people still mourn the loss of their Vioxx.  What happened?  A large research study put participants on Vioxx to see whether the NSAID would prevent colon polyps.  The researchers found the people taking Vioxx faced a larger-than-expected risk of heart attack and stroke.  The researchers stopped the study, notified the world, and the drug was pulled off the market by the manufacturer.  A second COX-2 NSAID, Bextra was taken off the market in 2005.  Today Celecoxib (Celebrex) is the only COX-2 NSAID still on the market in America. 

NSAIDs help many people dealing with arthritis pain.  Many such as ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn) are available over-the-counter.  At one time choosing an NSAID was simple because Vioxx was highly recommended by arthritis sufferers who found life easier and less painful when taking this drug.  However, it’s more confusing today.  The early NSAIDS can cause stomach upset, ulcers, and skin rashes.  The single COX-2 NSAID, Celebrex is still on the market.  A research study is underway now to compare Celebrex, Ibuprofen and Naproxen with a projected end date of 2014.  Would an NSAID be a good drug for you?  Talk to your doctor to get his recommendations regarding taking NSAIDS, whether over-the-counter or prescription.