Category: Pain Relief

New Pain Scale for Patients

Pain Scale

Nearly 25 million Americans experience acute pain each year as a result of injury, surgery, or disease. A new tool, the Ultra-cetTM Rapid Pain Response Scale (Ortho-McNeil), allows patients to characterize their pain through a series of questions designed to make it easier to describe and rate their experience of pain. Patients can use the scale to self-assess the effectiveness or side effects of any medication they are taking for pain control. The accompanying “Daily Diary” enables patients to record and communicate an accurate pain history to their physicians.
cymbalta drug

Successful Trial of Anticancer Drug Ends Early

Anticancer Drug

The first new treatment in more than a decade for patients with multiple myeloma, a cancer of the blood, has proved so effective that the manufacturer, Millennium, has halted the control arm of the trial to give patients receiving generic dexamethasone the option of immediately switching to bortezomib (Velcade™ for Injection, Millennium). The first of a new class of medications called protea-some inhibitors, bortezomib was compared with high-dose dexamethasone in a phase III trial of nearly 700 patients. An interim analysis found a statistically significant improvement in the time to disease progression.

COX-2 Inhibitors Do Not Prevent Alzheimer’s Disease

Alzheimer's Disease

Although scientists had hoped that the painkiller rofecoxib (Vioxx®, Merck) would help to prevent Alzheimer’s disease (AD), an earlier study this year found that this drug, along with naproxen generic (e.g., Aleve®, Naprosyn Drug, Roche) did not benefit patients who already had AD.

The findings were revealed at the annual meeting of the American College of Neuropsychopharmacology in San Juan, Puerto Rico. The study had enrolled 1,457 older patients with mild cognitive impairment, a group with risk factors for the development of AD. After half of the patients received rofecoxib therapy and the other half were given a placebo, it was found that AD developed in 6.4% of the rofecoxib group and in 4.5% of the placebo group. The study was discontinued after 189 cases of AD were observed.

On the surface, it appears that rofe-coxib caused AD in these patients, but an analysis of the patients’ cognitive abilities showed that the risk associated with the drug was similar to that for the placebo.

COX-2 inhibitors attack inflammation, and it had been thought that these drugs would be able to prevent AD by inhibiting inflammation of the neurons in the brain.

Combination Option for Patients with Arthritis

The FDA has approved a combination of the acid suppressor generic lansoprazole (Prevacid®, TAP) and the nonsteroidal anti-inflammatory drug (NSAID) naproxen (Naprosyn drug) for patients who must take NSAIDs to treat the signs and symptoms of rheumatoid arthritis (RA), osteoarthritis (OA), and ankylosing spondylitis. The product, called Preva-cid® NapraPAC™, has been found to reduce the risk of recurrent NSAID-associated gastric ulcers in patients with a history of these ulcers.

NSAIDs, such as aspirin and naproxen, can cause ulcers by interfering with the stomach’s ability to protect itself from gastric irritants, such as acid.

Prevacid® NapraPAC™ is available as a daily dose of one Prevacid 15 mg delayed-release capsule and two Naprosyn tablets of either 375 mg or 500 mg.

The product is contraindicated in patients with known hypersensitivity to any component of either drug. Naproxen is contraindicated in patients in whom aspirin or other NSAIDs or analgesic drugs induce the syndrome of asthma, rhinitis, and nasal polyps. Both types of reactions have the potential to be fatal. Other naproxen-containing products should not be used concomitantly.

Serious gastrointesinal bleeding, ulceration, or perforation can occur with or without warning symptoms in patients receiving chronic NSAID therapy.

Propoxyphene Napsylate plus Acetaminophen Combination for Pain

The FDA has approved propoxyphene napsylate and acetaminophen (Darvocet A500™, AAIPharma) for the treatment of mild to moderate pain. Darvocet A500™ is the only approved propoxy-phene napsylate/acetaminophen combination product that contains a lower dose (500 mg) of acetaminophen combined with 100 mg of propoxyphene napsylate. (Darvocet-N® 100 contains 100 mg of propoxyphene and 650 mg of acetaminophen.)
levaquin 750mg

The new product is expected to provide a unique formulation with the safety benefits of less acetaminophen and the full strength of propoxyphene. The FDA has established a 4,000-mg maximum daily dose of acetaminophen for adults, and physicians are concerned about patients who self-medicate using over-the-counter products.

COX-2 Inhibitors Do Not Raise Cardiovascular Risk

Cyclooxygenase-2 (COX-2) inhibitors now have an established reputation for causing less gastrointestinal toxicity than nonsteroidal anti-inflammatory drugs (NSAIDs). However, some speculation remains about a possible increased cardiovascular thrombotic risk, because COX-2 inhibition—unlike the simultaneous inhibition of COX-1 and COX-2 by NSAIDs—does not stop platelet thromboxane synthesis and, therefore, platelet aggregation. COX-2 inhibition also reduces systemic prostacyclin production, which may impair vaso-dilation. In addition, recent reports of a higher incidence of myocardial infarction (MI) in patients taking the COX-2 inhibitor rofecoxib (Vioxx®, Merck) have raised still more questions.

Despite these concerns, researchers from the University of Connecticut School of Medicine, Cornell University, and Yale School of Medicine, after analyzing the data on 31,879 patients in all completed clinical arthritis trials comparing celecoxib (Celebrex drug, Pharmacia) with NSAIDs and placebo, found no evidence of higher risk of MI, stroke, or cardiovascular death with celecoxib.

Patients taking celecoxib experienced 1.29 primary cardiovascular thrombotic events per 100 patient-years, and patients taking a placebo experienced a rate of 1.51 events.

In trials comparing celecoxib and NSAIDs, the rate was 1.13/100 patient-years with generic celecoxib and 1.05 patient-years with NSAIDs. The findings applied to all patients and to the 90% of patients who were not receiving aspirin at the same time.

Vioxx® Pulled from Market

Merck & Co. said that it is withdrawing its painkiller rofecoxib (Vioxx®), a flagship brand, which generated $2.5 bil lion in worldwide sales last year, because of data showing an increased risk of heart attack and stroke. The company’s shares fell 17%.

The decision to pull the drug from markets worldwide was based on a three-year study aimed at showing that a 25-mg dose could prevent polyps of the colon and rectum. The trial was stopped after Merck discovered a higher risk of cardiac complications after 18 months.

Vioxx® and Pfizer’s tablet celecoxib (Celebrex drug) were the first of a new class of medications designed to be gentler on the stomach than the older painkillers. Health insurers had said in August that they were considering discouraging the use of Vioxx® because of concerns about the heart risk.