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New Painkiller Causes Fewer GI Problems
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Page: << Prev | 1 | 2 | 3 | Next >> The researchers found that upper gastrointestinal problems were significantly less common with etoricoxib than with diclofenac. But, more serious gastrointestinal events, such as major bleeding, were the same in both groups. The effects of etoricoxib or diclofenac did not differ significantly in people using proton pump inhibitors or aspirin.
Laine said all cox-2 inhibitors carry a risk of heart attack and stroke. "One wouldn't expect this one (etoricoxib) to be different," he said. "But it could provide another option for patients."
The new trial was done as part of the U.S. Food and Drug Administration's approval process, Laine noted.
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Dr. Joost Drenth, of Radboud University Nijmegen Medical Center, the Netherlands, and author of an accompanying editorial in the journal, said there wasn't enough difference between the drugs in terms of gastrointestinal toxicity to show that etoricoxib was better.
"My advice would be to fall back to the good, old, classic NSAIDs with the addition of a proton pump inhibitor. Because we know adding a proton pump inhibitor to NSAIDs will decrease the incidence of dyspepsia," he said.
Another expert thinks etoricoxib and diclofenac are really two similar drugs, because diclofenac acts very much like a cox-2 inhibitor.
"It's not surprising that you don't see much of a difference when you compare Coke and Pepsi," said Dr. James M. Scheiman, a professor of medicine at the University of Michigan Medical Center.
Scheiman thinks the main concern with cox-2 inhibitors is weighing the cardiac risks with the gastrointestinal risks. "Which drug a patient should take is entirely driven by their underlying cardiac and gastrointestinal risk," he said. "Cox-2 inhibitors have a clear advantage on the gastrointestinal side when compared to drugs that aren't cox-2 inhibitors."
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Copyright © 2007 ScoutNews, LLC. All rights reserved.
Last updated 2/9/2007
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SOURCES: Loren Laine, M.D., professor of medicine, University of Southern California Keck School of Medicine, Los Angeles; Joost Drenth, M.D., Radboud University Nijmegen Medical Center, the Netherlands; Mark Fendrick, M.D., professor of internal medicine, University of Michigan School of Medicine, and professor of health management and policy, University of Michigan School of Public Health, Ann Arbor; James M. Scheiman, M.D., professor of medicine, University of Michigan Medical Center, Ann Arbor; Feb. 10, 2007, The Lancet
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