New Painkiller Causes Fewer GI Problems

But it's a cox-2 drug, which have been linked to heart problems, experts note.

By Steven Reinberg
HealthDay Reporter
Friday, February 9, 2007; 12:00 AM

Copyright © 2007 ScoutNews, LLC. All rights reserved.

FRIDAY, Feb. 9 (HealthDay News) -- A new cox-2 painkiller called etoricoxib causes fewer upper gastrointestinal problems than the traditional pain medicine diclofenac, researchers report.

"In the trial, there was a difference in the overall events between the two drugs," said lead researcher Dr. Loren Laine, a professor of medicine at the University of Southern California Keck School of Medicine. "There was not a significant difference seen in the more serious and less common events, like major bleeding. The difference was largely seen in the uncomplicated ulcers, which are symptomatic but not generally life-threatening."

The study is published in the Feb. 10 issue of The Lancet.

Etoricoxib (brand name Arcoxia) is a cox-2 inhibitor that has not been approved for use in the United States yet, although it is being used in Europe. Cox-2 drugs, such as Celebrex, Vioxx and Bextra, were developed to be less damaging to the stomach and intestinal tract. But, several of the cox-2 drugs have been linked to an increased risk of heart attack and stroke. As a result, Vioxx and Bextra were pulled from the market in 2004 and 2005, respectively. Celebrex is the only cox-2 inhibitor available to consumers. Etoricoxib is made by Merck & Co., the maker of Vioxx.

Diclofenac is a nonsteroidal anti-inflammatory (NSAID). NSAIDs such as diclofenac and aspirin are associated with gastrointestinal side effects, such as bleeding ulcers, when taken for an extended period.

In the new study, Laine and his colleagues analyzed data from three clinical trials, in which 34,701 arthritis patients were treated with etoricoxib or diclofenac. The patients were allowed to take additional medications called proton pump inhibitors, like Prilosec, to protect against gastrointestinal problems. In addition, patients with risk factors for heart attacks were allowed to take aspirin, which protects the heart.

The researchers found that upper gastrointestinal problems were significantly less common with etoricoxib than with diclofenac. But, more serious gastrointestinal events, such as major bleeding, were the same in both groups. The effects of etoricoxib or diclofenac did not differ significantly in people using proton pump inhibitors or aspirin.