Health

Arthritis Relief Without Strings

November 24, 1999 / 1:11 PM EST / AP

Two new drugs relieve arthritis pain as well as traditional, less expensive medicine and are less likely to cause stomach ulcers, researchers report.

Experts said it is uncertain whether the extra safety is worth the drugs' higher cost.

The drugs, Celebrex and Vioxx, gained government approval in the past year, generating more than 16 million prescriptions. They cost about eight times as much as older arthritis drugs.

Studies published in the Journal of the American Medical Association indicate the drugs act comparably to older medicines such as ibuprofen and naproxen in relieving arthritis pain but are far less likely to cause stomach ulcers, bleeding or intestinal obstructions.

One study analyzed eight trials involving 5,435 osteoarthritis patients and found that Vioxx, made by Merck and Co., was 50 percent less likely to cause gut perforations, ulcers and bleeding.

In the other study, involving 1,149 patients with rheumatoid arthritis, Celebrex, made by G.D. Searle & Co., provided comparable pain relief with only a 4 percent rate of tiny stomach sores. The ulcer rate for naproxen was 26 percent.

The studies were funded by the manufacturers and were part of the applications submitted to the Food and Drug Administration.

The new drugs improve on the older drugs, called nonsteroidal anti-inflammatory drugs, or NSAIDs, by acting more selectively. They inhibit only one form of a chemical that contributes to joint swelling but also protects the gut.

The older drugs help many of the estimated 19 million U.S. arthritis sufferers by relieving joint pain, but they also cause bleeding and other complications. An estimated 107,000 NSAID takers are hospitalized and 16,500 die yearly.

Until recently, the 40 percent of arthritis patients who were at especially high risk of developing bleeding ulcers either because of a history of ulcers or older age were prescribed NSAIDs along with a medication to protect the stomach.

Adding such a protective medication drives the low cost of NSAIDs (30 days of naproxen costs $9) to as high as $125, said an editorial in JAMA. By contrast, 30 days of Celebrex or Vioxx usually runs $72 to $85.

But for the larger group of patients, whose risk of severe complications from taking NSAIDs is low, more study will be needed to know whether the drugs are worth the price, the editorial said.