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Pain control is a big part
of arthritis treatment, and can be a challenge.
Sometimes your chosen
medication comes under attack for side effects, or reaction with other drugs,
sometimes those side effects or reactions are reported as life threatening, when
that happens, what are you to do? A good factual understanding of the issue is
essential to the decision making process.
Doctor... What Do I Do Now That They've
Taken Away My Vioxx!
By Nathan Wei
Ever since the huge tidal wave of publicity that surrounded COX-2 drugs
hit the American public, patients with arthritis have had to deal with the
consequences. While some deaths possibly could have been attributed to
cardiovascular side-effects, there has been a huge downside. This has been
the radical removal of medicines which had been the source of better
quality of life for thousands of patients.
So what are the options?
Well for one, there is still one COX-2 drug available. Celebrex has been
shown to be effective for pain associated with osteoarthritis and
rheumatoid arthritis. The down side is that patients with a history of
allergy to sulfa should not take it because of cross-reactivity. Also,
despite the touted safety for patients with prior peptic ulcer disease,
the benefit of COX-2 drugs has been negated when patients have had to take
concomitant aspirin therapy. Nonetheless, Celebrex remains a viable option
for patients who are in need of the benefits of COX-2 inhibition.
Older non-steroidal drugs also remain on the market. These include drugs
like Relafen, Lodine, Mobic, Daypro, Motrin, Naprosyn, and Voltaren.
Unfortunately, data has indicated that all non-steroidal drugs share an
increased risk of cardiovascular events. In fact, it appears that many of
the older drugs such as Clinoril and Indocin probably have a higher
cardiovascular risk than many of the newer medications.
Interest in nutritional supplements has also offered a possible
alternative. The recent NIH GAIT (Glucosamine/Chondroitin Arthritis Trial)
has been called a “negative” study by some. Nonetheless, 66% of patients
taking glucosamine/chondroitin benefited vs. 60% in the placebo group.
While the numbers may not be statistically significant, no one can explain
why the actual treatment group did better than the placebo group and why
animals studies also show a benefit. (It’s hard to fake placebo effect in
animals).
Non-drug therapies such as weight loss, thermal modalities (heat and
cold), topical agents (rubs), and exercise play an important role in the
management of arthritis.
Integrative therapies such as acupuncture, various herbal supplements, and
hypnosis might benefit some people.
Newer therapies such as electrical pulsed coils might also help. This type
of therapy has drawn much interest because of its non-invasive, non-drug
properties.
It’s important that patients consult knowledgeable rheumatologists to
assist them in their quest for safe, effective relief from arthritis pain.
Dr. Wei (pronounced “way”) is a board-certified rheumatologist and
Clinical Director of the nationally respected Arthritis and Osteoporosis
Center of Maryland. He is a Clinical Assistant Professor of Medicine at
the University of Maryland School of Medicine and has served as a
consultant to the Arthritis Branch of the National Institutes of Health.
He is a Fellow of the American College of Rheumatology and the American
College of Physicians. For more information on arthritis and related
conditions, go to: http://www.arthritis-treatment-and-relief.com
Article Source: http://EzineArticles.com/?expert=Nathan_Wei |
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