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A Second Cox and Bull Story for Pain Sufferers

Non steroidal anti-inflammatory drugs (NSAID’S) are a main stay for first line therapy for most acute and chronic pain sufferers. Our readers have asked my opinion on the new pain pills in town, the COX-2 Inhibitors.

There are two new NSAID’S , from two different drug companies, currently competing against each other.

Celebrex (celecoxib) by Searle was the first to hit the market with a big bang. It sales have done very well, clearly demonstrating the degree of pain present in North America. The second, Vioxx (rofecoxib), is made by Merck-Frosst and although it was actually discovered in Canada, it has recently been withdrawn from the market.

COX refers to the enzyme cyclo-oxygenase, of which there are at least two. Previous NSAID’s blocked both COX 1 and 2. 

COX 1, when blocked, can contribute to peptic ulcer disease and platelet function causing gastrointestinal ulcers and bleeding problems.

COX 2, when blocked, reduces the inflammatory response in the entire body.  Therefore where previous anti-inflammatories could contribute to bleeding problems and ulcers, these new COX 2 selective drugs are very powerful blockers of inflammation , with a much lower risk of causing ulcers and bleeding. This is very important because many people with arthritis often must take these NSAID’s for life and cannot risk a bleeding ulcer. It has been estimated that almost two thousand Canadians die of NSAID-related ulcers every year.

There is even the suggestion that Alzheimer’s disease  may be reduced by these new anti-inflammatories. (Advil and Motrin have shown risk reduction in Alzheimer’s disease).

As always, keep long and strong.