According to the Journal of the American Medical Association, about 30 million people around the world use NSAIDs for pain relief. The big concern with NSAIDs has been their possible toxic effect on the GI tract. NSAIDs have also been associated with kidney problems. In fact, JAMA estimates that around 2.5 million Americans experience kidney problems every year due to the intake of NSAID.

In the late 1990s, the Cox-2 inhibitor class of drugs (another type of NSAID), was introduced to the market, to provide an analgesic effect without the side effects on the GI tract. Research on kidney effects, however, has been less definitive, and a complete picture of how NSAIDS negatively affect kidneys has yet to be painted.

With Cox-2 inhibitors, all was seemingly well for a while, until a randomized, controlled trial (the most reliable kind of research study) showed increased risks for heart problems in those taking Vioxx. As many people vivdly remember, Vioxx was a very popular brand of Cox-2 inhibitors. Merck, Vioxx's manufacturer, was making quite a bundle on the drug in its heyday. In response to the study, Merck removed Vioxx from the market in September 2004. Following this was a cascade of events leading to labeling changes, law suits, more studies and the withdraw of Bextra, another Cox-2 inhibitor, from the market.

The awareness of the increased cardiovascular risk associated with Vioxx and Bextra has many people wondering if all drugs in the Cox-2 inhibitor class, i.e., those still on the market, will increase the possibility of heart disease in takers. Two recent studies, published in The Journal of the American Medical Society lend insight into this issue. About's Arthritis guides, Carol & Rick Eustice have the specifics of the studies' results. For the more scientifically minded, JAMA's website has reports on Cardiovascular Risk and Inhibition of Cyclooxygenase and Adverse Effects of Cyclooxygenase 2 Inhibitors on Renal and Arrhythmia Events.

Related Resources

• COX-2 Inhibitors and NSAIDs: JAMA Reports Offer Insight Into Cardiovascular Risks
• Vioxx Timeline
• What is Pain Medicine?
• NSAIDs

Sources:

• Patricia McGettigan, MD, FRACP; David Henry, MB, ChB, FRCP.Cardiovascular Risk and Inhibition of Cyclooxygenase. JAMA. Sept. 2006.
• Jingjing Zhang, MD, PhD; Eric L. Ding, BA; Yiqing Song, MD, ScD.Adverse Effects of Cyclooxygenase 2 Inhibitors on Renal and Arrhythmia Events. JAMA. Sept. 2006.
• David J. Graham, MD, MPh. Editorial - COX-2 Inhibitors, Other NSAIDs, and Cardiovascular Risk
• Carol and Rick Eustice.COX-2 Inhibitors and NSAIDs: JAMA Reports Offer Insight Into Cardiovascular Risks. About.com. Sept. 2006.
• Study shows drugs such as Vioxx and Celebrex were widely over-used long before recent problems. University of Chicago Hospital website. Jan. 2005.