Nail-Biting Time for Trials of COX-2 Drugs

摘要

Psychiatrist John Breitner was in a hotel V room in Sun City, Arizona, when he heard the news on television. It was 30 September, and CNBC was reporting that the COX-2 inhibitor Vioxx would be yanked off the market by its maker, Merck, after experts saw a frightening increase in cardiovascular side effects. Breitner's own heart skipped a beat. In an instant, he realized that his effort to stop Alzheimer's disease using Celebrex, a Vioxx competitor, had just gotten trickier. Breitner, an expert on aging based at the University of Washington, Seattle, is one of dozens of researchers exploring whether COX-2 inhibitors can do more than they were designed to do—ease the painful inflammation of arthritis. Over the years, animal studies have suggested that these medications, along with more traditional nonsteroidal anti-inflammatory drugs (NSAIDs), may be able to lower the risk of cancer and reduce inflammation suspected in Alzheimer's. In the past few years, scientists have launched one study after another to put these hopeful ideas to the test. The pace picked up after the U.S. Food and Drug Administration (FDA) confirmed data in 1999 showing that Celebrex reduces intestinal polyps in patients with familial adenomatous polyposis, a hered- itary condition that leads to colon cancer. Excitement has focused on COX-2 inhibitors because they are believed to be less likely than NSAIDs to cause stomach problems, a big drawback in long-term prevention trials.