Protective Partners for Arthritis Drugs

Arthritis patients taking COX 2 inhibitors benefit from gastroprotective agents

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Some drugs used to relieve the pain of arthritis can do damage to your digestive tract. This is why many arthritis patients take other medications to protect their digestive system.

Patients taking cyclooxygenase-2 (COX-2) inhibitors may be putting themselves at risk of gastrointestinal complications if they do not take their gastroprotective medications.

"Talk to your doctor before quitting any prescription drugs."

Two of the most common types of drugs used to treat arthritis pain are non-steroidal anti-inflammatory drugs (NSAIDs) and COX-2 inhibitors, which include Celebrex (celecoxib), Vioxx (rofecoxib), and Arcoxia (etoricoxib). Both of these drug types are known to irritate the digestive tract.

Past research has shown that patients who take NSAIDs and fail to take their gastroprotective drugs (drugs designed to protect the digestive tract) may have an increased risk of gastrointestinal complications. However, there has been little research on how adherence to gastroprotective drugs affects patients taking COX-2 inhibitors.

Now, a recent study - which was conducted by Dr. Vera Valkhoff, of Erasmus University Medical Center in the Netherlands, and colleagues - suggest that patients taking COX-2 inhibitor should be taking gastroprotective drugs such as proton pump inhibitors or misoprostol.

Their findings show that the risk of upper gastrointestinal complications among COX-2 inhibitor users was higher in those with low adherence to gastroprotective drugs, compared to those with full adherence.

For every 10 percent decrease in a patient's adherence to gastroprotective drugs, there was a nine percent increase in risk of gastrointestinal complications.

According to Dr. Valkhoff, this study confirms gastroprotective drugs reduce the risk of gastrointestinal problems caused by COX-2 inhibitors.

Some COX-2 inhibitor users have a higher risk of gastrointestinal complications because they have a history of gastrointestinal problems, a risk factor that cannot be changed. However, adherence to gastroprotective agents is something that patients can control.

This study - which involved more than 14,000 patients prescribed COX-2 inhibitors and gastroprotective drugs - was funded by AstraZeneca.

Study co-authors Dr. Molokhia, Dr. Goldstein, Dr. Hernandez-Diaz and Dr. Kuipers have received fees from a number of different drug manufacturers, including AstraZeneca, Pfizer and Merck. 

The research was published July 27 in the journal Arthritis & Rheumatism.

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Review Date: 
April 15, 2012
Last Updated:
August 26, 2012