Recall of Bextra
After Pfizer Inc. announced it was suspending its arthritis pain reliever Bextra, the world's biggest drugmaker saw its first-quarter net income plunge 87 percent. Pfizer said it took a $766 million charge for suspending sales of Bextra after the FDA concluded the drug's risks outweighed any benefits.
The promise of Bextra
Bextra was created in the late 1990s by the G.D Searle & Co. division of Pfizer Pharmaceuticals for the handling of arthritis, inflammation, and painful menstrual cramping without the risk of severe stomach irritation. Clinical tests of arthritis patients over six months showed the relative safety of Bextra, and it was approved by the FDA on November 16, 2001. Bextra became one of the best selling drugs on the market, with sales in the tens of billions of dollars. Doctors were happy with the low percentage of stomach irritation, and patients were pleased with the boost in quality of life that these alleged "wonder drugs" provided. However, concerns about Bextra's role in heart attacks, strokes, and dangerous skin reactions caused the FDA to ask manufacturer Pfizer to stop selling the drug in April, 2005.
What are the alternatives for people who no longer have access to Bextra?
Both Vioxx and Bextra have been taken off the market, leaving arthritis patients confused about how to safely get effective pain relief while protecting their hearts and stomachs. According to a new study, the majority of arthritis patients may be advised to use a combination of two drugs - a non-COX-2 pain reliever like Aleve, Advil or Motrin and a gastro-protective medicine like Prilosec or Nexium. Some experts believe this drug combination may have always been the best solution.
With Bextra off the market, are there effective alternative ways to treat pain?
The latest drug recalls of prodects like Bextra and Vioxx and drug warnings on drugs such as Celebrex have left millions of people wondering what to use for relief. A new study suggests over-the-counter heat wraps may help people trying to manage arthritis and other chronic pain. A study funded by Procter and Gamble, the makers of ThermaCare heat wraps, looked at 110 men and women with osteoarthritis of the knee. Given either acetaminophen, ibuprofen or a placebo, and wearing a wrap with no heat or a ThermaCare heat wrap for eight hours a day, researchers found that those receiving the heat treatment had significantly less pain, a better range of motion and more reduced disability than those treated with any of the other options.
How does Bextra work?
Relieving the pain of inflammation traditionally involved targeting chemical messengers that cause tissue to inflame. One very important chemical messenger is an enzyme called cyclooxygenase-2 or COX-2 for short. Unfortunately, it is very similar in chemical makeup to the Cyclooxygenase-1 (COX-1) which plays an important role in protecting the lining of the lower stomach. Traditional anti-inflammation drugs like asprin or ibuprofen indiscriminantly block both COX enzymes, so one could get relief from inflammation, but at a cost to the health of one's stomach. New COX-2 inhibitor drugs like Bextra were designed to target the COX-2 enzyme, but not the COX-1 enzyme. This would allow patients who could not tolerate traditional anti-inflammatory medications to get relief for arthritis pain.
How Bextra Works
Bextra belongs to a new class of drugs called COX-2 inhibitors. These are newly developed drugs for inflammation that selectively block the COX-2 enzyme. Blocking this enzyme impedes the production of the chemical messengers that cause the pain and swelling of arthritis inflammation. Cox-2 inhibitors are a new class of nonsteroidal anti-inflammatory drugs (NSAIDs). Because they selectively block the COX-2 enzyme and not the COX-1 enzyme, these drugs are uniquely different from traditional NSAIDs such as asprin, ibuprofen, naxopren, piroxicam, or nabumetone.