News January 2006 Issue

In the News: 01/06

NSAID And Aspirin Use Increase GI Bleeding Risk

Patients who combine the over-the-counter (OTC) pain relievers ibuprofen or naproxen with aspirin double or triple their risk of serious gastrointestinal side effects.

According to a study presented during a recent meeting of the American College of Gastroenterology, 38,507 patients on ibuprofen (200mg/day) and 11,957 patients on naproxen (200mg/day) were shown, respectively, to have 2.5 to 2.74 greater risk of experiencing such stomach problems as ulcers, perforations, or bleeding than those who did not take the pain-relievers. An examination of sub-groups of ibuprofen and naproxen users who also took aspirin showed an even greater risk of serious GI problems—3.4 times greater than patients who took ibuprofen alone, and two times greater than those who took naproxen alone.

Researchers concluded that aspirin not only significantly increases the risk of gastrointestinal problems among patients using ibuprofen and naproxen, but that the practice of adding aspirin to painkillers to mitigate cardiovascular risks has become all too common. The study’s recommendation: Take a daily aspirin, in addition to your pain-reliever, if you’re at risk for heart disease. If you’re not, taking aspirin will increase your risk of gastrointestinal problems.  


Olive Oil For Pain Relief?

Most have read or heard about the cholesterol-lowering benefits of olive oil. But here’s equally good news: A compound found in olive oil—the freshly pressed, extra-virgin variety—inhibits the activity of COX-1 and COX-2 enzymes, acting the same way as nonsteroidal anti-inflammatory drugs (NSAIDs) do to reduce the inflammation that plays a major role in arthritis.

Based on a report in a recent issue of the journal Nature, Gary Beauchamp, Ph.D., of the Monell Chemical Senses Center in Philadelphia, found that premium olive oil irritated the back of his throat the same way that ibuprofen did. To confirm his suspicions, he and fellow researchers isolated what they believed to be the compound, reproduced it synthetically, found that it produced the same throat “sting” as premium olive oil, and named the compound oleocanthal (oleo=olive, canth=sting, al=aldehyde).

The sensory similarities between oleocanthal and ibuprofen led the team to further investigate their common pharmacological properties. Results showed that, like ibuprofen, oleocanthal inhibited COX-1 and COX-2 enzymes, an action that underlies the anti-inflammatory properties of ibuprofen and other NSAIDs, suggesting that oleocanthal is a natural anti-inflammatory agent. Researchers suggested that oleocanthal may play a key role in the health benefits associated with diets, such as the Mediterranean diet, where olive oil is a principal source of fat.


Doxycycline May Slow OA Progressio—But Not Pain

Doxycycline, a common antibiotic, may slow the progression of osteoarthritis. According to a recent study published in Arthritis & Rheumatism, researchers found that doxycycline slowed the erosion of cartilage, allowing joints to move more smoothly. The study examined 431 women with OA in one knee who took 100mg of doxycycline or a placebo twice a day for 30 months. X-rays were then taken at 16 months and 30 months. Levels of joint pain were assessed every six months. At the end of 30 months, the loss of joint space was 33 percent less in the doxycycline group than in the placebo group. Despite slowing cartilage destruction, however, doxycycline did little to reduce pain (although pain did not worsen). Researchers suggest joint pain may serve as an indicator of synovitis (inflammation of the joint-lining membrane), which can lead to cartilage destruction.

Said Brian Donley, M.D., vice-chairman of the Department of Orthopaedic Surgery at The Cleveland Clinic and AA’s Editor-in-Chief, “This study is an excellent foundation for further research. However, the findings are largely preliminary. The study looked at only X-ray findings, not at what is going on at the cellular or clinical level. Importantly, it did not show improvements in pain. What all people with OA want is pain relief—not better-looking joint spaces. Losing weight, staying active, and exercising to strengthen your joints will always be the most important part of any OA treatment strategy.”