This news is all over TV today. Not unusual that Dow Jones is down again, as it was when Vioxx was withdrawn on September 30.

Pfizer is probably going to say that the doses employed were twice the usual dose for arthritis, which would give the company a little wiggle room. But that is little comfort to those now using it, who I predict will stop using it en masse.

This would be true as well for Pfizer’s other product, Bextra, which Dr. David Graham of the Office of Drug Safety already warned of possible similar side effects as Vioxx when he appeared before the Senate Finance Commidttee.

This announcementn today will likely hasten
changes many felt were needed at the FDA.

Dr. Centor,

The NEJM does not carry the Celebrex report. The study that led to today’s announcement was the APC study – a NCI trial of colorectal adenoma prevention using celebrex. It has not been published yet, not even in abstract form, I believe. The Safety Monitoring Board sent a review to Pfizer with the prelim analysis last nigh, leading to this morning’s announcement.

The only ‘report’ (and the one you are showing in your post) is an AP news article.

What is on NEJM is a letter from Drs. ray et al advising to stop prescribing valdecoxib as well.

I have some details on my blog , should anyone be interested.

Patients who go off COX-2 drugs will likely go to In response to the comment about the potential side effects of “traditional” NSAID’s or opiates,” well, yes, all drugs have side effects. However, one always has to weigh benefit and risk. In the case of vioxx, for example, the benefit certainly did not outweigh the risk. Up to 100,000 people may have suffered a stroke or heart attack for taking a drug that was, if you will, not “necessary.” By not necessary, I mean that it was not for a life threatening condition. There are alternatives, which have side effects as was pointed out, but I don’t know of any data indicating that 100,000 have had strokes due to over the counter NSAIDS. Celebrex now appears to be going down the same road as Vioxx. Merck didnn’t want to voluntarily withdraw Vioxx, even after the evidence became overwhelming.

Have we pulled the older NSAID’s off the market because they caused renal dysfunction or GI bleeds?

My comment (#5) posted above under “Aleve” is also pertinent here. Other observations:
1) Dr Graham, while entitled to his opinions, has made projected estimates of worst case scenarios; there is little hard data, and Graham’s numbers are just spin about mortality risk; he may be wrong by a log order or even more!
2) the CV risk, even if real, may be a dose threshold phenomenon (like water intoxication).
3) Obviously, a controlled trial, stratifying CV risk, and using usual doses of COX-2’s is the next step.