TONY HARRIS, CNN ANCHOR: Drugmaker Pfizer says new research shows its popular painkiller Celebrex may increase some patients’ risk of cardiovascular problems. The drug has been prescribed to some 27 million Americans since being approved by the FDA in 1998 for arthritis pain. It is the most common arthritis drug on the market, with annual sales estimated at more than $3 billion. So what does this discovery mean for people using Celebrex?
Dr. Laurence Sperling is a cardiologist at Emory University in Atlanta and he joins us now to talk about this. Doctor, good to see you.
DR. LAURENCE SPERLING, CARDIOLOGIST, EMORY UNIVERSITY: Good to see you, too. Hi.
HARRIS: All right, I need you to help me, here, I need you to walk me through this. I’m a middle-aged man, I like to play tennis, I like beat up on Kyra Phillips over here on the tennis court. But when I do, my knee my surgically-repaired knee tends to flair up a little bit. OK, I’ve been prescribed Celebrex. Tell me why the drug that helps me with my inflammation, my swelling in my knee, might cause me some problems with my heart.
SPERLING: If we look at this drug, it is an anti-inflammatory agent. It also affects a certain enzyme in the body. And this enzyme blocks cicloxanase (ph), too.
HARRIS: Now what OK.
SPERLING: So this is cox-2, it’s how it acts, by blocking up the enzyme. By doing that, there might be an increase in a parallel enzyme in the body that may cause an increase in the tone of the blood vessels. May increase the stickiness of platelets in the body and may increase problems with our blood vessels.
HARRIS: That cuts to clogging and those kinds of problems.
SPERLING: That’s correct.
HARRIS: We’re talking about blockage, is that what we’re talking about? Blocking the…
SPERLING: Blockage and change in the blood vessels themselves, the tone of the blood vessels and maybe the reactivity of the blood vessels.
HARRIS: OK, but I am a heart healthy young man. Should I still be concerned about possible side effects that you’ve described here?
SPERLING: Right now with our available information, I would say that I’d be a little wary of prescribing Celebrex to you right now.
HARRIS: At this moment.
SPERLING: At this moment.
HARRIS: Because of this information?
SPERLING: Certainly because of the evolving information we’ve seen related to this whole class of agents right now.
HARRIS: Now these are the cox-2 inhibitors that we’re talking about?
SPERLING: That is correct.
HARRIS: Talk about this evolving body of knowledge on this class of drugs.
SPERLING: Really, initially, about four years ago or so, there were questions related to the possible heart side effects of these medications. In these studies, nobody specifically asked the question about heart side effects, but these were byproducts of these studies. As you well know, one of these agents was recently taken off of the market because of the increase in heart side effects.
HARRIS: So what do you do if you have these arthritic problems, if you have this kind of swelling? What are you prescribing now?
SPERLING: Right now I certainly would work along with your doctor, but there are many garden variety anti-inflammatory agents and pain medicines that are available, like Tylenol, over-the-counter medicines that have been tried and true for a long period of time that thus far certainly have not shown an increase in heart attacks or heart blood vessel problems.
HARRIS: With the way things have gone for Vioxx, what is the evidence and then this alert, I guess we can qualify it as an alert today. What is the evidence likely to be that would preclude Pfizer from taking it off the market, following the path of Vioxx? If we’ve already been issued this kind of alert, which is kind of a pattern we saw with Vioxx.
SPERLING: Right now I certainly think, if we look at the evidence, we can say that if you have known heart disease, if you’re an individual with high risk for heart problems, that you should shy away from this class of agents at this present time. If we see further evidence after looking at these studies that there is an increased problem, even in people who are the average joes with knee problems, and we really are not sure about that question right now, clearly, that would indicate the need to take these off the market.