Posted on 04/04/2006 9:55:13 PM PDT by neverdem
Associated Press
WASHINGTON — Is a drug that might lower the risk of colon cancer worth taking if it also raises the risk of heart problems? That's a question people most likely to develop the deadly bowel disease may be asking after the latest research on the popular arthritis drug Celebrex.
Two studies found the drug cut the chances of developing precancerous growths called polyps by 33 percent to 45 percent in people who already had had such growths removed.
However, experts said the extra heart problems seen in those taking the drug mean it can't be recommended for preventing cancer in people at average or slightly higher risk.
"We are all concerned about cardiovascular events," said Dr. Nadir Arber of Tel Aviv Sourasky Medical Center in Israel, who led one of the studies.
Still, experts were excited by how much potential the drug showed for cancer prevention.
"It lays a huge foundation for the future. ... This is an extremely promising start," said Dr. Ernest Hawk of the National Cancer Institute, which paid for one of the studies.
It's an important issue: More than 145,000 new cases of colorectal cancer and about 55,000 deaths from it are expected to occur this year in the United States.
The studies were presented Monday at a conference of the American Association for Cancer Research. They are the latest chapter in the saga of cox-2 inhibitors, painkillers that block a substance that causes inflammation and also is found in many tumors. Aspirin also blocks this substance, and studies suggest that it, too, cuts the risk of colon cancer, but it is tough on the stomach and can cause bleeding problems.
Doctors hoped that cox-2 inhibitors would be better, but Celebrex is the only one still on the market; Vioxx and Bextra were withdrawn over safety concerns.
In fact, a study testing Vioxx for cancer prevention led to the discovery of its heart risks in September 2004 and prompted researchers to suspend similar studies testing other cox-2 drugs against cancer.
Two of those suspended studies produced the news reported on Monday.
One, funded by the government and Celebrex's maker, Pfizer, involved 2,035 people in the United States, England, Australia and Canada. They were given either 200- or 400-milligram doses of Celebrex twice a day or a placebo, and then checked one year and three years later with colonoscopy exams.
More than 60 percent of those on a placebo developed new polyps, but less than half of those on Celebrex did, said Dr. Monica Bertagnolli of Harvard-affiliated Brigham and Women's Hospital in Boston.
About 3.4 percent of those taking the drug had heart attacks, strokes or other serious heart-related problems versus 2.5 percent on a placebo.
A second study, paid for by Pfizer and led by Arber, who owns stock in the company, reached similar conclusions. Nearly 1,600 people in 32 countries who had previous polyps were given either 400 milligrams a day of Celebrex or a placebo.
Three years later, new polyps had been found in 34 percent of those given the drug and 49 percent of the others.
Heart-related side effects ranging from chest pains to heart attacks occurred in 7.5 percent of those on Celebrex versus 4.6 percent of those on a placebo.
It's a tradeoff. There will always be tradeoffs...
Mayor Bloomberg, M.D. The nanny city might lose a ton of money from lawsuits.
Massachusetts Sets Health Plan for Nearly All I'm sceptical about Romney's big gamble, but if he can pull it off, he takes a big issue off the table.
FReepmail me if you want on or off my health and science ping list.
Celery and carrots will give you cancer
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