Vioxx's Heart Risk Lingered Long After Use Ended

Some danger may come with other NSAID pain relievers, experts say

By Steven Reinberg
HealthDay Reporter

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MONDAY, Oct. 13 (HealthDay News) -- When the pain killer Vioxx was pulled from the market in 2004 over concerns that it increased the risk of heart attack, stroke and death, many assumed that stopping the drug would end the risk.

But a new study finds that "the risk was increased close to twofold, and the risk persisted for approximately a year," said co-author Dr. Robert Bresalier, a professor of medicine at the M.D. Anderson Cancer Center in Houston.

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"The good news is that, after a year, the risk seemed to go back down toward normal," he said.

However, the study's researchers and other experts also believe that long-term use of most non-aspirin painkilling drugs in this class -- called non-steroidal anti-inflammatory drugs (NSAIDs) -- also boost users' risks of heart attack, stroke and death to some degree.

NSAIDs include cox-2 inhibitor drugs such as the now-banned Vioxx and Bextra, as well as the remaining cox-2 on the market, Celebrex. Those drugs target the cyclooxygenase 2 (cox-2) enzyme involved in inflammation.

NSAIDs also include less targeted anti-inflammatory medications such as ibuprofen (Advil, Motrin) and naproxen (Aleve).

The report was published online in the Oct. 14 issue of The Lancet.

For the study, Bresalier's group followed people who had participated in the international APPROVe trial, which compared Vioxx to placebo over 3 years in an attempt to see whether the drug could cut the recurrence of cancerous colon polyps. The trial was stopped early in 2004 because of the increased risk for heart attacks and stroke.

The researchers in the new study were able to contact 84 percent of the almost 2,600 people who had participated in the trial.

They found that a year after discontinuing Vioxx, ex-users still had a 79 percent increased risk of heart attack, stroke or death compared with those who had received placebo.

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