By
Rosemary Frei, Medical Tribune News Service
ORLANDO,
Fla. -- People taking the new drug celecoxib to treat inflammation
and pain from arthritis are less likely to have bleeding ulcers
and other digestive-tract complications than those taking older
anti-inflammatory, according to a study released here Tuesday.
Dr.
Jay Goldstein, the Chicago gastroenterologist who led the study
and reported it at the annual Digestive Disease Week meeting,
found that under 1 percent of patients suffered such complications
while taking celecoxib. The same study found just under 2 percent
of patients taking older drugs had these problems.
Goldstein
and his colleagues at the University of Illinois studied 11,007
arthritis patients taking either celecoxib, three different non-steroidal
and anti-inflammatory drugs (NSAIDs) or no treatment, for two
24 weeks. Celecoxib, sold as Celebrex by Pfizer, is an anti-inflammatory
drug.
The
patients had a tota1 of 101 complications involving the gastro-intestinal
tract, of which 11 were judged by a committee of three gastroenterologists
to be significant.
Two of those events were experienced by the 1,O20 patients taking
celecoxib, for a total of 0.2 percent annual incidence, and nine
were experienced by thc 535 patients taking NSAIDs, for a total
of 1.7 percent annual incidence.
Dr.
Byron Cryer, an associate professor of gastroenterology at the
University of Texas Southwestern Medical Center at Dallas, noted
that while the results are promising, it would be important for
the researchers to report how many of the gastrointestinal events
that were not judged to be significant by doctors were experienced
by patients in each of the three treatment groups. ``As gastroenterologists,
we want to base our decisions on those adjudicated cases. But
we would be more confident if the cases included those other patients
-- because 90 is a huge number.''
Arthritis
affects one in six Americans, or nearly 43 million people in 1997.
It causes more disability in the United States among those 15
or older than high blood pressure, heart or lung ailments, or
diabetes
NSAIDs
work by blocking the action of two chemicals known as COX-1 and
COX-2. COX-1 is found in the body normally and helps protect the
gastrointestinal tract, while COX-2 is usually found only in inflamed
tissue. Researchers believe NSAIDs irritate the stomach because
they blunt COX-1's protective effect. Celecoxib sidesteps this
problem by blocking COX-2 alone.
Approved
by the Food and Drug Administration in late 1998, celecoxib was
the first COX-2 inhibitor to go on the market in the United States.
The wholesale price for the drug is $2.42 for a 200-milligram
capsule.
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