Prexige: A New Painkiller For Arthritis Pain
18 Aug 2007
For three million Canadians, osteoarthritis can be a debilitating disease that can affect not only their ability to function in their day-to-day lives, but leaves many depressed and isolated.
A few years ago a number of these drugs were removed from the market. But this has left many patients confused, frightened under-treated and living in pain. Some people had to give up their favourite sport, gardening, a daily walk, find it difficult to navigate the stairs or even open a bottle. The options available for these people just don’t work, have intolerable side effects or pose more risk than benefit.
During the last few years 34,000 patients around the world participated in a study to evaluate whether a new non-steroidal anti-inflammatory drug was safe for doctors to prescribe. They all suffered from a variety of arthritic pain. The result is that Prexige, is now available to treat the pain and inflammation of osteoarthritis (OA).
Today over 22 million North Americans suffer this debilitating disease, the wear- and-tear type of arthritis, where bones eventually grind on bones. Older NSAIDS such as ibuprofen and naproxen are good for treating pain but not always kind to the stomach.
These drugs affect an enzyme called COX-1 that normally protects the stomach’s lining. This may result in sudden unexpected bleeding from a gastrointestinal ulcer. Most people are unaware that 2,000 Canadians and 16,000 people in the U.S. die every year from this complication, a huge price to pay for pain relief.
A study in the England used an optical instrument to examine the stomachs of patients after using the older NSAIDs. The results were shocking. Doctors reported that, after two months use, one in five patients had a stomach ulcer without symptoms, one in 70 a painful ulcer, one in 50 a bleeding ulcer and one in 1200 died from a gastric hemorrhage.
In a Danish study researchers tracked 207,000 people for 19 years who had been on the older NSAIDs to determine the extent of intestinal bleeding. It showed that these drugs increased the risk of bleeding five times. For those over 75 years of age the risk was 27 times greater. And in the U.S. 107,000 people are hospitalized every year due to intestinal side-effects of NSAIDs.
Researchers designed new drugs such as Celebrex, Bextra and Vioxx to protect the stomach’s lining by preserving COX -1. But soon Vioxx and Bextra were removed from the list of painkillers due to its increased risk of cardiovascular disease. Doctors were left with only one choice.
Having only effective drug is always a poor option for doctors and patients. As Dr. Bensen, a prominent rheumatologist at McMaster University in Hamilton, says, "The more options we have, the easier it will be for us to prescribe the right medicine, to the right patient, at the right dosage, for the right duration."
So the arrival of Prexige is an important milestone in the fight against pain and inflammation of osteoarthritis. Studies show that patients with osteoarthritis using Prexige are79 percent less likely to develop gastrointestinal complications than those using the older NSAIDs, ibuprofen and naproxen. And none of the Prexige patients developed intestinal erosions.
Moreover, patients using Prexige did not experience any increase in heart attack or stroke compared to naproxen and ibuprofen. And Prexige had 80 percent less impact on blood pressure than patients taking the older NSAIDs. And it’s a convenient once-daily dose of 100 milligrams. But recent reports show that this dose should not be increased as it can cause serious side effects. And patients with liver problems should not take Prexige.
Osteoarthritis is a major problem for this country. This disease accounts for 50 per cent of all chronic conditions over the age of 65. And in Canada the annual economic cost is 4.4 billion dollars. But what we tend to underestimate is the day-after-day agony of those afflicted with osteoarthritis and its affect on the psyche.
The many e-mails and letters I receive from readers with osteoarthritis often comment on their helplessness. Perhaps a new option will provide them with not only safe and effective pain relief, but hope they can get back, to living their lives.
