News February 2004 Issue

In the News: 02/04

Celebrex Or Vioxx? It’s A Toss Up
Despite some heated claims and counter-claims, selective COX-2 inhibitors celecoxib (Celebrex) and rofecoxib (Vioxx) have been found to be equally effective. This was the finding following a study by Dr. Allan Gibofsky and his colleagues at Cornell University’s Weill Medical College. The head-to-head, placebo-controlled test, reported in the November 2003 Arthritis & Rheumatism, involved 475 patients with knee osteoarthritis who were given celecoxib (200mg/day), rofecoxib (25mg/day), or a placebo. Patients’ pain scores—assessed at the beginning of the study, after week three, then after week six—were found to have not only improved, but there was no distinguishable difference between the effect of the two coxibs (the differences, when compared with the placebo, were significant for both treatments). The study, funded by Celebrex manufacturer Pharmacia, was vehemently called into question by Northwestern University’s Dr. Thomas Schnitzer, senior author of an earlier study funded by Merck, the manufacturer of Vioxx. Schnitzer objected to the manner in which pain scores were assessed.

Meanwhile, in another study, this conducted at the New Zealand Pharmacovigilance Centre, it was found that visual impairment as a result of taking either coxib may be more prevalent than is commonly thought. Author Dr. David Coulter reported that the reaction is “underrecognized”; although the World Health Organization Center for International Drug Monitoring contains 470 reports of visual disturbances with coxibs, only one case has been published.The good news: Vision loss, either slight or severe, is likely to be temporary. Recovery, noted Dr. Coulter, occurred within one to two days of stopping the drug.

----------

Build Bones with Vitamin K—Vitamin K?
Vitamin K isn’t exactly a “celebrity” vitamin. But this low-profile vitamin, known primarily for its ability to help coagulate blood, is starting to change its image. According to research reported by the Mayo Clinic, some studies have found a positive relationship between Vitamin K and bone health. Although results are not yet conclusive, it’s been found that low Vitamin K is associated with increased incidence of hip fractures in the elderly. Additionally, women on Vitamins D and K for two years experienced increased levels of bone density. Vitamin K is found in many food sources, including spinach, broccoli, and brussels sprouts. It is also found in multivitamins and some calcium supplements. For women, the recommended daily dose is 90 micrograms (mcg); for men, it’s 120 mcg. People who take blood-thinning medications such as warfarin (Coumadin) are advised to take Vitamin K with caution, since it can reduce the effectiveness of the medication.

----------

High Heels, Firm-Mattress Myths Debunked
The belief that knee osteoarthritis has been linked to physical stress on the knee joint, and the fact that it is more common among women than men, has led to speculation that high heels may be to blame. However, Jill Dawson, Ph.D., and her colleagues at Oxford Brookes University in England have determined otherwise. After interviewing 29 women awaiting knee replacement and 82 women with no knee pain, they discovered that wearing high heels—especially dancing in three-inch heels—had a slightly protective effect against knee arthritis. What does cause knee arthritis? Dawson’s claim, based on clues uncovered during the study: Women who became overweight before age 40 were much more likely to need knee replacement.

Another belief recently called into question is the long-held notion that people with lower back problems should sleep on a firm mattress to alleviate back pain. However, a study conducted among 313 subjects at the Kovacs Foundation in Spain found that a medium-firm mattress led to a sounder, more pain-free sleep. Patients who slept on medium-firm mattresses, which better adapted to the natural curves of the spine, were twice as likely as those sleeping on a firm mattress to experience reduced pain while lying in bed or getting up in the morning. The study found its subjects also experienced less disability associated with back pain and were less apt to rely on pain-killing drugs.