Dateline: 1/07/99

The FDA has approved Celebrex -- the first of a new kind of painkiller called COX-2 inhibitors for patients in pain from rheumatoid arthritis and osteoarthritis.

Celebrex is the culmination of trials to find medication that relieves pain just as well as other non-steroidal anti-inflammatory drugs (NSAIDS) -- such as ibuprofen, aspirin, and naproxen -- but does not cause the stomach problems so often associated with these drugs.

Pfizer will market Celebrex, the Cox-2 inhibitor made by Searle, a division of Monsanto, winning the race against Merck's Vioxx, another COX-2 inhibitor. Merck hopes to file for FDA approval for its Vioxx drug later this year. Vioxx is designed as a once-a-day pill, while Celebrex will have to be taken several times daily.

More than 3 million Americans suffer from rheumatoid arthritis, and nearly 16 million suffer from osteoarthritis. Both conditions cause pain and joint deterioration.

COX-2 (cyclooxygenase-2) is an enzyme identified as one cause of pain and inflammation in arthritic joints.

COX-2 inhibitor medications simply stop the enzyme from causing the pain.

COX-1 helps maintain platelet and kidney function, while COX-2 produces substances that cause joint inflammation.

Other NSAIDS work by blocking enzymes known as COX-1 and COX-2. Celebrex blocks only COX-2, providing pain relief without stomach trouble. Therefore, it is hoped that Celebrex will be safer than other NSAIDS for long-term use.

The long-term use of NSAIDS can lead to stomach ulcers and gastrointestinal problems. These are the primary reasons many patients cannot take NSAIDS at all or must limit their usage to the point where they lose the benefits NSAIDS provide.

According to a report in USA Today, scientists are also researching the use of COX-2 inhibitors in Alzheimer's disease, colon cancer, kidney disease, and bone deterioration.

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