What Ever Happened to Last Year’s Wonder Drug?

The media in North America seems perpetually hungry for news of the latest pharmaceutical advances. This stems from the fact that the population is becoming more and more enamoured with drugs and vaccines. Increasingly, we are being led to believe that our future as healthy people can only be assured if we make greater use of ever more complicated and expensive pharmacological remedies. Contrary to their usual pattern of dealing in bad news, the media typically report only good drug news, especially when something brand new is being touted.

Case in point, the class of non-steroidal anti-inflammatory drugs known as Cox 2 inhibitors. The names that I am focusing on here are 2 drugs that have been the medical 'flavours-of the-day' for several years now: celebrex and vioxx. When these drugs hit the market, there was an intense flurry of news reporting activity, both in the public media as well as in professional journals. We were told that these drugs were going to end once and for all time the problem of stomach and intestinal complications from taking anti-inflammatory medication.

Personally, I never did understand why a drug that is supposed to reduce inflammation could possibly cause such severe inflammation of the intestinal linings. Best estimates on the use of regular non-steroidal anti-inflammatory drugs (or NSAID's) such as Naprosyn, Anaprox, Advil, Indocin, etc. etc. are that they cause 32,000 hospitalizations and 3,200 deaths in the United States every year due to gastrointestinal ulcers. So enter the miracle Cox 2 inhibitors Celebrex and Vioxx to save the day.

These two drugs became overnight successes, rapidly becoming the most prescribed pain medication and earning enormous, almost obscene profits for Pharmacia and Merck, the manufacturers. Celebrex hit the street first and enjoyed a short-lived corner on the pain control market. Vioxx followed soon thereafter and rose to second place until the FDA took a closer look at the original research submitted by Pharmacia when approval for Celebrex was attained. "Hold it," the FDA said, "these results are phony!" Actually, on September 17, 2001, they said "There is not a proven clinically important safety advantage in upper gastrointestinal events..."

Vioxx is marginally better at offering its users GI protection, but both companies have been scathed by the FDA for their advertising. "You have engaged in repeated promotional activities that minimize the potential serious risk of using Celebrex and Coumadin concomitantly." Merck had received similar chastisement for Vioxx.

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