Currently 420,000 British patients take Celebrex.
70% of those take a dose of 200 milligrams or less.
But 25% take 400 milligrams or more daily.
http://www.channel4.com/news/2004/12/week_3/18_drug.html
Drug doubts
Published: 18-Dec-2004
By: Sarah Smith
There are questions tonight over whether a drug for arthritis, used by four
hundred thousand people in the UK, should be prescribed at all.
Channel 4 News has learnt that one of the country's leading hospitals is
considering alternatives to prescribing the drug Celebrex, after one study
by the drug company Pfizer found it can double the likelihood of strokes and
heart problems.
This latest scare comes less than 3 months after a similar drug was
withdrawn because it increased the risk of cardiovascular problems.
Heavily advertised in America, Celebrex is widely prescribed, alleviating
arthritis pain without the risk of stomach ulcers.
But patient may have more serious side effects to worry about - heart
attacks or strokes.
Now some Doctors are likely to stop prescribing the drug here:
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"Now it appears, although it might be safe on the stomach, it may cause more
problems like heart disease and strokes and so the patient might not get a
gastro-intestinal bleed but they might have a heart attack, so in that
situation we can't use them in the majority of patients".
Dr Michael Ehrenstein Consultant Rheumatologist, UCH
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Currently 420,000 British patients take Celebrex.
70% of those take a dose of 200 milligrams or less.
But 25% take 400 milligrams or more daily.
Patients on these higher dosages could be at risk.
Pfizer, the drugs' manufacturers stress that people on lower dosages do not
suffer the same risks.
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"What we have is a very surprising result from one of two studies, the
relevance of which for the vast majority if patients benefiting from
treatment with Celebrex we don't yet fully understand.
Hank McKinnell, Chairman, Pfizer
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Before those results were released, Pfizer ran adverts this week claiming
Celebrex posed no risk to the heart.
They had hoped that Celebrex could also prevent colon cancer. But their own
trial found instead it more than doubled the risk of heart problems.
Another similar drug, Vioxx, was recently withdrawn for the same reasons.
Many patients were moved onto Celebrex instead.
Pfizer say it doesn't carry the same risks but patients will still be
concerned
These drugs are all cox-2 inhibitors.
They prevent joint inflammation and reduce pain. Originally prized for their
lack of side effects, they may pose much greater dangers and at greater
cost.
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"Cost is an important factor, because the alternative, which is a standard
analgesic arthritis drug plus this drug that protects against ulcers, is
5-10 times cheaper and since there's no evidence it's worse, in terms of
safety or effectiveness, we are also partly driven by cost.
Dr Michael Ehrenstein
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One billion pounds were spent on Celebrex last year.
Now American doctors are being urged to use alternatives and the European
Medicines Agency is investigating the risks.
Pfizer don't plan to withdraw it though and patients should talk to their
doctors before they stop taking it.