Cox2 inhibitors from the viewpoint of patients

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Cox-2 inhibitors from the viewpoint of patients
Cosima K. Kliebenstein MSc

• Symposium Geneesmiddelenbulletin
• 8 November 2006

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Cox-2 inhibitors

• Cox-2 inhibitors were expected to be a good
  alternative for traditional NSAIDs
• Withdrawal of Vioxx in September 2004
• At the time of withdrawal
• More than 300.000 users of Vioxx
• Ex-Vioxx users had many questions and
  complaints
• Patients felt as if there was no authority to
  turn to

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From the users of VIOXX (1)
I used Vioxx for two years. My former painkiller
(Naproxine) gave too many (stomach) complaints.
My GP prescribed Vioxx. What concerns me is that
I did not hear anything from my GP or pharmacist
when the news about the side effects of Vioxx was
announced. I had to learn the facts about Vioxx
from the news. And on my own request my GP
prescribed me another drug!

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From the users of VIOXX (2)
I took Vioxx for only 3 months, which was very
effective! I heard through the news that Vioxx
was withdrawn from the market. I had heard
nothing from my GP. After I asked my GP about it,
he prescribed Celebrex. My pain decreased, but I
also suffered from several side effects, which I
thought to be caused by my menopause or increased
activities (due to less pain) My GP doesnt react
to my complaints and I get the feeling that Im
whining, so I no longer ask any questions.

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From the users of VIOXX (3)
For a period of 5 years my physician prescribed
Vioxx. I am now 52 years old, so I did not think
it was strange to suffer from pressure on my
chest, heavy perspiration etc. I thought it was
the menopause. After the withdrawal of Vioxx, I
started taking Celebrex. But I stopped taking it
a few weeks ago because I heard that it belongs
to the same category as Vioxx. I have
Fybromyalgia with a lot of pains and
tiredness. I dont know what to do.

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Patients interests

• Good communication with the physician about all
  aspects of possible treatment, including drug
  policy
• Full information from the physician on the
  benefits and side effects of a drug
• That physicians take the complaints of patients
  seriously
• That the physician is up to date on recent
  developments and includes these in the treatment
• That the physician is informed by an independent
  body about the reliability of the drug and/or
  treatment and alters this when necessary.

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The Vioxx Reporting Center

• Patients wanted to tell their story
• Vioxx Reporting Center was launched at the
  beginning of 2005
• Start of a study on patients complaints of side
  effects of Vioxx
• Presentation of the reports results in December
  2005
• Contribution of the report to the medical world
• Valuable information of experienced side effects
  by patients
• Complaints experienced by patients were broader
  than mentioned in earlier research or as listed
  in the instruction leaflet
• Incentive for further research on Cox-2
  inhibitors

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Conclusion

• Starting point is the well being and health of
  the patient
• Patients should be able to make a well informed
  choice concerning the treatment of their illness
• Patients should be able to rely on full and
  unbiased information from their physician on the
  possible side effects of drugs
• Physicians should be able to rely on outcomes of
  research on the possible side effects of drugs.

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Recommendations

• (More) independent scientific research on safe
  (long term) treatment of illness is necessary
• Periodical information to physicians by an
  independent authority about the latest
  independent research results
• Information on side effects of drugs should be
  easily accessible, understandable and in the
  public domain
• Improved communication between
• authorities and professionals
• physicians and their patients

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