Vioxx, Celebrex raise death risk after heart attack: study

BEIJING, Nov. 14 -- COX-2 inhibitors, such as Merck's Vioxx and Pfizer's Celebrex, increase the risk of death among patients who have already survived a previous heart attack, according to data released Sunday at the American Heart Association conference.
This is the latest in a string of bad news regarding the COX-2 drugs, also known as non-steroidal anti-inflammatory drug (NSAIDs), once a popular class of painkillers that generated billions of dollars in annual sales.
Patients who have heart disease should not use these types of drugs, according to Dr. Gunnar Gislason, the lead independent researcher in the study.
"These results are a cause for concern but not panic," said Gislason. "If you can avoid them, it makes sense to switch to another type of medication if you have cardiovascular disease."
The Gislason study was based on the medical records of more than 58,000 Danish patients released from hospitals following their first heart attack between 1995 and 2002.
Researchers compared the risk of a second heart attack or death from any cause during the time patients were on various NSAIDs compared to patients who were not.
Taking almost any NSAIDs, especially in high doses, raises patients' risk of death, the results showed.
"The most important thing to recognize is that higher doses give a higher risk of death," Gislason said.
Excluded from this study is the use of aspirin. "There is no doubt about the beneficial effects of aspirin among patients after heart attack, which is a cheap and effective treatment -- and the scientific evidence is undeniable," Gislason said.
"We have not yet seen the study," said Merck spokesman Chris Loder, who noted that drug safety is typically established through randomized controlled clinical trials, which is different from the type of study conducted by Gislason.
Pfizer executives were not immediately available to comment.