Eliminating Painkillers - Naproxen To Follow Vioxx, Celebrex

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Management of chronic pain is getting more difficult - at least the much touted chemical route seems to be turning into a rather rocky path, with several of the "blockkbuster" painkillers showing stunning rates of increase of heart trouble after Vioxx was recently withdrawn from the market. According to a recent Health News article, the FDA has just halted a clinical trial involving Naproxen, as signs emerged that the drug seems to be a cause of increasing heart trouble just like its cousins.

Of course this brings us to a painful question: Should we at all routinely "manage pain" or is it perhaps time to look at underlying mechanisms, to find out what causes the pain and remedy that underlying cause? Certainly pain is an important indicator that something is not right. But would you plaster a piece of paper over the red light in your car that indicates the oil in your motor is getting too hot? Certainly not. So why do we insist on "managing pain" as a routine strategy in healthcare, without a corresponding and vigorous investigation of what caused the pain in the first place, and a equally vigorous effort to eliminate whatever is found as the cause?

One of the great causes of pain is of course another class of drugs - statins - which are taken in order to "reduce cardiovascular risks". Millions of people take statins in a misguided effort to lower cholesterol, when again, cholesterol has never been shown to be the cause of cardiovascular events and lowering cholesterol has not been shown to lower the risk of having a heart attack. But one of the side effects of statins is atrocious muscle pain, enough to put a good part of those millions of statin users onto painkillers that - incredible but true - are found to cause heart attacks.

For now there is little cause for optimism, as research has been directed mainly into pharmaceutical strategies of "treating" disease, rather than into understanding and devising strategies to heal the underlying causes.

One non-pharmaceutical strategy that is emerging is pain relief through acupuncture.

Another bright spot is recent research into the mechanisms of arthritis, which promises a way to turn off the pain involved with the autoimmune reaction that causes the disease.

A more effective course of action on autoimmune diseases such as arthritis however would be to research and understand the regulatory mechanism of the immune system, something proposed by immunologist Thad Wendel. Such an advance would allow us to intervene in a more targetted way and perhaps eliminate much of the toxic "medicine" we routinely introduce into our bodies.

(original at HEALTH NEWS)

Now It's Naproxen - Strike Three Against Athritis Pain Meds

Contributed by Carla Sharetto | 21 December, 2004  02:47 GMT

Still reeling from Merck's  withdrawal of Vioxx from the market and Pfizer's decision to stop advertising Celebrex, people who suffer from arthritis pain now have one more worry: The U.S. Food and Drug Administration announced Monday that it was halting a clinical trial involving naproxen, sold under the brand names Naprosyn (Roche Pharmaceuticals) and Aleve (Bayer), due to increased cardiovascular risk.

The FDA released the following statement regarding its decision to end a clinical trial involving non-steroidal anti-inflammatory drugs in patients at risk of developing Alzheimer's Disease:

FDA Statement on Naproxen

"The Food and Drug Administration (FDA) is working with the National Institutes of Health to review the available scientific information on naproxen following the decision of the National Institute on Aging to halt a clinical trial studying non-steroidal anti-inflammatory drugs in patients at risk of developing Alzheimer's disease.

"Preliminary information from the study showed some evidence of increased risk of cardiovascular events, when compared to placebo, to patients taking naproxen.

"In the meantime, FDA advises patients who are currently taking over-the-counter naproxen products to carefully follow the instructions on the label. Patients should not exceed the recommended doses for naproxen (220 milligrams twice daily) and should not take naproxen for longer than ten days unless a physician directs otherwise. Patients with questions about naproxen should consult their physicians."

Naproxen was first sold as a prescription drug under the trade name Naprosyn in 1976. The FDA approved its use as an over-the-counter drug in 1994. It is frequently used to combat the pain of arthritis.

Arthritis Foundation Comments on COX-2 Inhibitors

Responding to the concerns over Vioxx and Celebrex that have shaken the pharmaceutical world in recent weeks, the Arthritis Foundation also advises arthritis sufferers to engage in a dialogue with their healthcare practitioners.

"This is an opportunity for people taking COX-2 inhibitors to have a discussion with their doctor about medications and other approaches to treat their arthritis," said Dr. John H. Klippel, president and CEO of the Arthritis Foundation. "In addition, people should pay attention to the importance of exercise or weight loss in the management of arthritis. And for some people who really are impaired by arthritis, this might be the time to even begin to think about surgery."

In the meantime, the Arthritis Foundation urges caution in the use of COX-2 inhibitors in people at risk for cardiovascular complications. The Arthritis Foundation recommends that people considering or taking COX-2 inhibitors work with their doctor to determine a treatment plan for their arthritis that is best for their individual situation.

While Vioxx has been recalled from the market, Celebrex is still available for use.

Good News About Acupuncture

Also in the news are findings of a study showing that acupuncture is an effective treatment for reducing pain and improving functionality in patients who have osteoarthritis of the knee.

Participants receiving acupuncture versus other treatment options had a 40 percent decrease in pain and a nearly 40 percent improvement in function compared to baseline assessments.

posted by sepp

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