New arthritis drugs decrease ulcer risks

Since I’ve been suffering from the pain of an arthritic hip following a tennis injury, I have more than a casual interest in arthritis. To get the latest information, I recently attended the Annual European Congress on Rheumatology in Prague, Czech Republic.

In particular, I wanted to determine the effectiveness and safety of the new COX-2 inhibitors-Celebrex, Vioxx and, the newest one, Mobicox.

This latest class of nonsteroidal anti-inflammatory drugs (NSAIDs) is supposed to reduce the risk of causing gastrointestinal irritation and ulcers.

Many seniors affected
Seniors who suffer from osteoarthritis, the wear-and-tear type, have lots of company.

This disease accounts for half of all chronic conditions in people aged 60 and over. It’s a debilitating condition:

• 80 per cent of patients experience some degree of limitation of movement
• 25 per cent cannot perform noal daily activities.

Treating the pain of arthritis with NSAIDs has been a risky affair, balancing the benefits of the drug that provides the greatest benefit while producing the least risk of side effects.

Ulcer problems common
A study from the United Kingdom used an optical instrument to examine the stomachs of patients using the older NSAIDs. The results were shocking.

Doctors reported that, after two months:

• One in five NSAID users has an ulcer that is present but not causing symptoms
• One in 70 has a painful ulcer
• One in 150 has a bleeding ulcer
• One in 1,200 will die from a gastric hemorrhage.

This means that in the United States, 107,000 people are hospitalized every year due to gastrointestinal side effects of NSAIDs.

And of these 16,500 people die. In Canada, 1,900 die annually from serious uncontrolled gastrointestinal problems.

Next page: Kinder to stomach

Kinder to stomach
Studies presented by several world authorities in Prague had reassuring news about the new NSAIDs. We’ve been aware that these new medications were kinder to the stomach but not sure of the extent.

Now studies show that the new NSAIDs decrease the risk of ulcer complications by 88 per cent. This is a huge benefit that enables everyone to sleep better.

The 88 per cent figure also means that fewer patients on the new NSAIDs have to stop taking these drugs due to side effects.

It also means fewer visits to doctors for upset stomachs.

Equally important, there are fewer expensive hospitalizations for either bleeding or perforating ulcers. In the U.S., it’s estimated that the side effects of NSAIDs cost $1 billion annually.

What are risks?
But I wanted another question answered at this meeting. I wanted to determine whether the new NSAIDs had any adverse effect on either the cardiovascular system or kidneys.

Dr. Gurkipal Singh of the Stanford University Medical Center, who conducted studies on Mobicox, presented reassuring data.

An analysis of 15,000 patients revealed no greater risk of either cardiovascular problems or kidney injury. This is contrary to what has been seen with some of the other treatments in this class.

Please explain. Does this mean Mobicox doesn’t have the risk of cardio & kidney problems seen with Celebrex and/or Vioxx?

Dr. Henry M. Rinder of the Yale School of Medicine had this to say, “Mobicox has been prescribed in more than 45 million cases worldwide and we are pleased to see these new data on this drug.”

Destroys bad enzymes
So why are new NSAIDs so much better than the older ones? The traditional NSAIDs destroy COX-1 and COX-2 enzymes.

COX-1 is a good enzyme that normally protects the stomach’s lining.

The new COX-2 drugs are more protective of this important enzyme while inhibiting the production of COX-2. That’s why Mobicox and the other new NSAIDs have become the gold standard for easing arthritic pain.

Cost argument
Some contend that the newer NSAIDs are more expensive. But they forget that the use of Mobicox at 78 cents a day will save health care dollars when patients suffer from fewer complications.

Besides, when this medication gets me back on the tennis court, I’ll gladly pay the 78 cents a day.