Wednesday, December 06, 2006

More on Vioxx

Vioxx is the first COX2 that was withdrawn from the US market in 2004, because of the reported increased incidence of CVS and cerebral events with the use of Vioxx. Almost 20 million patients worldwide, have been taking Vioxx and there are 7,000 lawsuits pending in USA and 11 other European countries, against MSD, the makers of Vioxx. So far, 11 or more suits have been settled, primarily in USA. 7 of the 11 that was decided by jury, were decided in favour of MSD. The legal liabilities for MSD, on this issue is a staggering USD 5BN, enough, I think to do MSD in.

With all these legal suits going on, 7,000 suits in USA tried to get the US courts to allow for a class action suit against MSD, obviously on the premise that the Vioxx cardiovascular side-effects is due to Vioxx, and not the individual patient subset, whereas, MSD is contending that the unfortunate patient CVS side-effects were due to the concomitant patient co-morbidities and not directly due to Vioxx. Believe me, the difference is so fine that perhaps only the lawyers can tell the difference. Be it as it may, the US court decided that the 7,000 odd suits cannot be lodge together as a class action. Thus making MSD very happy.

At the end of the day, and together with our previous postings, it does look like there is a problem with COX2 and the heart, but it may be a class effect, common to the other COX2 as well, perhaps to varying degree. For the many who need COX2, it may be wise to consider taking the COX2 that you like, with a small dose of aspirin (that is what I tell my patients), or go back to the COX1 inhibitor and use some PP inhibitor to help the stomach (like what I do, when I have to play golf). I am sure that moe news is yet to come. We have not heard the last word on this yet.

1 comment:

view from the fareast said...

cox2 + PPI + aspirin, where are we going. From my interactions I feel that first there is hardly a need for regular long-term use of cox2 inhibitors (MSD was just greedy). Nobody has done a lon-term study with other NSAIDs and looks like naproxen too is sharing some risk of CVD. Any grandfather textbook will say that these drugs retain sodium and after spending millions we agree to that! Probably for OA and RA prn use of NSAID with disease modification is the way to go, no regular NSAIDs.