Selected research from leading health care experts whose findings have a direct bearing on public policies effecting medical progress. Research is chosen based on its quality and relevance by the Medical Progress Today editorial staff.

Selected Research

Heart Attack Risks, Pain Relief Similar for Most Osteoarthritis Drugs
Agency for Healthcare Research and Quality, 9-26-06

As we noted earlier, the discovery of risks associated with new drugs can actually help uncover unsuspected risks of similar treatments that doctors have prescribed for decades, simply because we now have the technology and infrastructure to analyze larger population groups for more subtle safety signals. This study, from the Agency for Healthcare Research and Quality at the U.S. Department of Health and Human Services, compares drugs in the same class as Vioxx (COX–2 inhibitors) with traditional painkillers (called NSAIDS), and finds that they have similar risks and benefits.

Two classes of drugs commonly used to treat osteoarthritis–non–steroidal anti–inflammatory drugs (NSAIDs) and COX–2 inhibitors (a newer generation of NSAIDs)—present similar, increased risks of heart attacks while offering about the same level of pain relief, according to a new report by the Department of Health & Human Services' (HHS) Agency for Healthcare Research and Quality (AHRQ).

The exception is the drug naproxen, commonly sold as Aleve or Naprosyn, a medication that scientific evidence suggests presents a lower risk of heart attack for some patients than other NSAIDs or COX–2 inhibitors, the study concluded. Researchers emphasized in their analysis, however, that all drugs pose potential harms along with benefits. Patients differ widely on how they react to drugs, how they prioritize risks, and whether risks are acceptable when compared to a drug's benefits. Patients should talk to their doctors before changing any medications.

The report, authored by AHRQ's Evidence–based Practice Center at Oregon Health & Science University, was based on a systematic review of 360 published studies and represents the most comprehensive analysis thus far of arthritis pain medications. Researchers compared the pain medications' effectiveness and health risks, including heart attack and gastric side effects, plus identified topics where more research is needed. While the review yielded important findings about the painkillers, it concluded more studies are needed about the drugs' comparative risks, the consequences of long–term use, and the impact of dosing variations. The authors also suggested that genetic research may one day predict which patients are most likely to develop cardiovascular problems when taking the analgesics.

"These findings represent a vital comparison of medications that are taken by millions of Americans," said AHRQ Director Carolyn M. Clancy, M.D. "The report also shines a bright light on questions that could further our knowledge and give patients research–based evidence to help them choose the best available treatment."

Project FDA.
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