News June 2003 Issue

In the News: 06/03

Arthritis Plus Ulcers? Pricey COX-2 Inhibitors Not Your Only Option
If you suffer from arthritis and have a history of ulcers, stomach-friendly but expensive COX-2 inhibitor drugs (Vioxx, Celebrex, Bextra) aren't your only option, according to a recent study in the New England Journal of Medicine. A traditional nonsteroidal anti-inflammatory drug (NSAID), when paired with an ulcer drug, may prevent bleeding just as well. The study involved 287 patients who had used NSAIDs for their arthritis and developed bleeding ulcers—a potential side effect of using any anti-inflammatory drug. After the ulcers healed, half the group took celecoxib (Celebrex) and the other half took a traditional NSAID, diclofenac (Cataflam, Voltaren), plus the acid pump inhibitor omeprazole (Prilosec). Over the following six months, the chance of suffering bleeding ulcers again was found to be about 5 percent in both groups. The study suggests that people whose drug plans don't cover the relatively expensive COX-2 medications could use a lower-cost traditional NSAID paired with an ulcer drug. With either therapy, the risk of kidney harm is still high (25 to 30 percent in this study), so those with arthritis who take NSAIDs long-term or at high doses should do so only under a doctor's supervision.

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Strong Back Muscles Protect Against Spinal Fractures
If you suffer from osteoporosis or are at risk of developing it, you can prevent spinal fractures by strengthening your back muscles. And the best way to do that, according to researchers at the Mayo Clinic, is through exercise. A recent Clinic study of 50 postmenopausal women found that those who completed two years of back-strengthening exercise were 2.7 times less likely to experience a compression fracture. Further, the effect of exercise was found to last for up to eight years. For starters, see “Six Fixes For Lower Back Pain” in our Jan. 2003 issue. Before beginning any exercise program, check with your doctor. He may be able to recommend specific exercises that can help prevent bone loss.

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NSAIDs Seen As Preventative Against Lung Cancer . . .
Regular use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may protect smokers against lung disease. According to a recent study reported in Cancer, smokers and former smokers who regularly use NSAIDs at least three times a week were less at risk for lung cancer compared to those who did not use NSAIDs. Similar benefits were seen for smokers who used aspirin, although reduced cancer risk was found only in men and not in women. High levels of enzymes called prostaglandins (PGs), linked to the growth of tumor cells, are found in lung cancer tissue. COX-2, a form of the enzyme cycloexygenase, synthesizes PG and has been found to be elevated in a variety of cancers. Clinical trials, as a result, have begun using selective COX-2 inhibitors to treat cancers. But now, less expensive over-the-counter NSAIDs also show the promise of eradicating lung disease. Says Joshua E. Muscat, lead author of the study, “These results provide the strongest evidence to date for the chemoprotective effect of NSAIDs.”

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. . . And Alzheimer’s Disease
Yet another benefit of taking NSAIDs to ease arthritis pain is the protective effect that such drugs may offer in fighting Alzheimer’s disease. Dr. Bas in’t Veld of the Erasmus Medical Center in Rotterdam, Holland, has discovered in a study of nearly 7,000 people age 55 and older that those who had used NSAIDs for two years or more had 80 percent less risk of developing Alzheimer’s disease. Another report, from scientists at the University of California (San Diego), suggests that the benefits of NSAIDs may not be due to their anti-inflammatory properties. Rather, they may result from the fact that these drugs lower levels of a peptide which forms the plaques in the brain that are characteristic of Alzheimer’s disease.