The research compared the cardiovascular health of 18,523 osteoarthritis patients over 50 years of age who were all taking high doses of one of three pain medications, either lumiracox­ib (e.g. Prexige, sometimes misquoted as “Prestige” by the media), ibuprofen (e.g. Act-3, Advil, Brufen, Dorival, Herron Blue, Panafen, Motrin, Nuprin) or naproxen (e.g. Aleve, Anaprox, Naprogesic, Naprosyn, Naprelan, Synflex).

The study group included patients considered at high risk for “cardiovascular events” -mostly heart attacks. Some of these patients were taking low-dose aspirin, a common preventa­tive treatment that helps thin the blood to help prevent blood clots, and some who were not tak­ing any aspirin. In the patients taking low-dose aspirin, ibuprofen was associated with a dramat­ically higher incidence of heart attacks than either lumiracoxib or naproxen. The researchers concluded that ibuprofen must somehow interfere with the protective blood thinning properties of aspirin.

Medications such as lumiracoxib are called “selective COX-2 inhibitors”, which is a type of NSAID (nonsteroidal anti-inflammatory drug). Medications such as ibuprofen and naproxen are called “non-selective non-steroidal anti-inflammatory drugs” or NSAIDs. Aspirin itself was the first discovered member of the NSAID class of drugs.

According to the National Institutes of Health, selective COX-2 inhibitors and NSAIDs both increase the risk of heart attacks, which may happen without warning and may cause death when aspirin is not present. But research had been lacking in the high cardiovascular risk popu­lation of patients taking aspirin in combination with these pain medicines used for osteoarthri­tis.

“Ibuprofen has a significantly higher rate of major cardiovascular events, mostly heart attacks, when compared to a COX-2 inhibitor,” said Dr. Michael E. Farkouh, M.D., of Mount Sinai, the lead investigator. “The findings underscore the importance of not only considering the class of NSAIDs used in high risk cardiac patients with osteoarthritis but also making physicians aware of the interaction of NSAIDs with aspirin, diminishing any beneficial effects.

“Doctors should not give high risk cardiovascular patients ibuprofen for pain while they are taking aspirin for their heart. Cardiologists, rheumatologists and gastroenterologists need to work together to fully evaluate the evidence at hand to make proper recommendations to pri­mary care physicians.”

SOURCE: Mount Sinai School of Medicine, Press Release, April 2007 http://fusionanssm.edu/media/content.cfm?storynum=31 (All brand name drugs listed above are registered traademarks of their manufacturer.)

Researchers in Spain under the direction of Dr. Jorge Vas, M.D., surveyed 5,981 patients who received Acupuncture treatment over a 9-year period. Their aim was to determine the effectiveness of treatment programs in helping patients deal with pain. A telephone survey was conducted to inter­view each of the patients. Persons with cancer-related pain were not included in the study.

In undertaking this task, researchers recorded the type of pain medications taken by each patient prior to beginning their Acupuncture regimen and at the end of their treatment plan. They also recorded information about the retail cost of those drugs. A 5-point scale was then used to assess consumption of the pain-reducing drugs, as follows:

0: No painkillers were required.

1: Occasional painkiller use, but below the recommended amount.

2: Using the recommended dosages in accordance with clinical guidelines.

3: Taking an increased dosage from the recommended amount.

4: The continued increase of painkiller types and amounts.

First off, it was interesting to note from the study’s findings that of the 5,670 patients who com­pleted the survey, there were no adverse reactions recorded from Acupuncture treatment. Next, headache sufferers enjoyed the greatest relief from their pain. In addition, headache sufferers had the greatest dollar savings on drugs. Finally, persons with sub-acute (less than severely sharp) pain expe­rienced a greater degree of relief than those with continuing or chronic painful symptoms.

Upon further assessing the information collected, here is what the researchers discovered about Acupuncture and drug cost savings:

1. The average savings in drug costs was $9.70 per week per patient.
2. The greatest savings was for patients with headaches at $35.70 per week. 3. The smallest savings was for patients with neck pain at $9.02 per week.

“The favorable response rate obtained for most of the patients, the absence of severe adverse events and the reduction in the consumption of analgesic (pain reducing) and anti-inflammatory drugs all suggest that our experience could profitably be extended to other primary healthcare clinics for the treatment of nonmalignant pain,” said the researchers.

Source: Acupuncture Today. October 2007. http://www.acupuncturetoday.com/mpacms/at/article.php?id=31586