Other prescription painkillers for arthritis may prompt serious adverse side effects

Where’s Waldo?

In the wake of the Vioxx scandal we’ve learned that other prescription painkillers for arthritis may also prompt serious adverse side effects.

Take Celebrex, for instance. The information flyer for this drug tells us that liver and kidney damage are possible outcomes – just as they were with Vioxx.

But what about heart attack risk? According to a long-term study of more than 8,000 subjects that appeared in a 2000 issue of the Journal of the American Medical Association, the heart attack rate among both Vioxx and Celebrex users was “significantly higher” compared to placebo. And while the study indicated that Vioxx was the more dangerous of the two, Celebrex was by no means risk-free.

Fortunately, there are safe, natural alternatives to Celebrex. In fact, a recent study demonstrates how a combination of two treatments (both well known to many HSI members) may be just as effective as Celebrex.

Weight bearing relief

Osteoarthritis (OA) is a form of arthritis that causes painful inflammation of the joints and loss of cartilage. It can be especially worrisome on large joints that bear weight, such as the knees and hips.

Last month, a study that examined treatments for OA of the knee was presented at the annual scientific meeting of the American College of Rheumatology (ACR). Funded by the National Institutes of Health, the study compared Celebrex to supplements of glucosamine and chondroitin sulfate. These two essential components of cartilage are naturally produced by the body, and in supplement form have been shown to slow and even reverse the degenerative effects of osteoarthritis.

A team of researchers led by Daniel O. Clegg, M.D., chief of the Division of Rheumatology at the University of Utah School of Medicine, recruited nearly 1,600 subjects with OA of the knee. Each had experienced significant knee pain for at least six months. Subjects were randomly assigned to these five treatment groups:

  • Glucosamine, 500 mg three times each day
  • Chondroitin sulfate, 400 mg three times each day
  • Glucosamine, 500 mg combined with 400 mg of chondroitin sulfate three times each day
  • Celebrex, 200 mg per day
  • Placebo

Pain levels for each subject were assessed before the intervention began, and four more times throughout the 24-week study period. Final results showed that Celebrex was the most effective painkiller for those with mild OA pain. But for subjects with moderate to severe pain, the combination of glucosamine and chondroitin sulfate was comparable to the effectiveness of Celebrex.

In an ACR press release Dr. Clegg noted that, given the results, “patients might want to discuss treatment options with their physicians.”

A spicy alternative

In previous e-Alerts I’ve mentioned this important word of caution: OA patients should avoid chondroitin sulfate supplements if they have prostate cancer or if their doctors feel they might be at risk of developing prostate cancer. Reports have shown that chondroitin sulfate may cause prostate cancer cells to multiply and spread to other sites.

This is NOT true of glucosamine, which can be safely used by prostate cancer patients.

But those who can’t use chondroitin sulfate might consider combining glucosamine supplements with ginger extract, another natural treatment that’s been shown to relieve pain associated with OA of the knee.

In the e-Alert “Root of Relief” (3/31/04), I told you about a small study in which knee pain was reduced and mobility significantly increased among subjects who used ginger extract. And similar results were reported in a University of Miami study that tested ginger extract (255 mg per day for six weeks) on more than 240 patients with mild to severe OA of the knee.

“Glucosamine and Chrondroitin Sulfate may be Useful for Patients with Moderate to Severe Pain from Knee Osteoarthritis” The American College of Rheumatology, 11/13/05, rheumatology.org