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The introduction of the first COX-2 inhibitors (Pfizer’s Celebrex in 1998 and Merck’s Vioxx in 1999) was one of the most sensational pharmaceutical triumphs in decades. Here was a new class of drugs that researchers hoped would improve quality of life for tens of millions of people. Drugs that would alleviate the pain of arthritis and other inflammatory conditions, without the stomach irritation or internal bleeding that aspirin and ibuprofen can cause.

The much heralded new drugs quickly became the best-selling medications of all time. Unforunately, within a year of introducing Vioxx to the marketplace, Merck researchers learned from their own research (the so-called VIGOR trial) that users of Vioxx had a 4 to 5-fold increase in heart attacks. Some experts estimate that these drugs have been responsbile for hundreds of thousands of deaths. Ironically, a recent study in the Annals of Internal Medicine discovered that patients who are already at a higher risk of cardiovascular disease are more likely to be prescribed COX-2 inhibitors than regular NSAIDs, despite clear evidence that these drugs sharply increase the risk of heart attack.

After being briefly pulled from the market due to safety concerns, Vioxx was ultimately returned to the marketplace because FDA investigators were convinced that for some people, the potential benefits outweighed the risks. A new study reported in last week's British Medical Journal, however, confirms several previous studies which found that Cox-2 inhibitors are in fact no gentler on the stomach than traditional pain relievers. In other words, these extremely expensive drugs, which carry very serious risks, offer few if any substantial benefits over safer drugs like ibuprofen.

Those suffering from arthritis or other inflammatory conditions should also be aware that nutritional approaches, such as an anti-inflammatory diet and fish oil supplements, can bring substantial relief without the risks, side effects, and expense of drugs. The many health benefits of an anti-inflammatory diet also include a reduced risk of heart disease, cancer, and Alzheimer's disease.

For more information: The Inflammation-Free Diet Plan

Sources: Hippisley-Cox J, Coupland C, Logan R. Risk of adverse gastrointestinal outcomes in patients taking cyclo-oxygenase-2 inhibitors or conventional non-steroidal anti-inflammatory drugs: population based nested case-control analysis. BMJ. 2005 Dec 3;331(7528):1310-6.Link to study