More research promotes NSAIDs as a preventive "wonder drug"

Forehead Slapper

“A widely prescribed pain reliever may one day have value in helping to prevent lung cancer.”

When I read that opening sentence from a recent HealthDay News report, I literally slapped my forehead.

Oh brother. Here we go again

Choose your poison

Before I share with you one of the most unbelievable quotes I’ve ever read (contained in the HealthDay report), let’s back up just a bit to a more innocent time (last month) when studies about the unconventional use of non-steroidal anti-inflammatory drugs (NSAIDs) didn’t cause nearly as much forehead slapping as they do now.

In the e-Alert “Double Crossed” (5/25/08) I told you about a long-term trial that tested two NSAIDs – naproxen (Aleve) and Celebrex – as potential Alzheimer’s disease (AD) preventives.

Fortunately or unfortunately (depending on your point of view) neither of those products seemed to prevent Alzheimer’s. In fact, subjects who took naproxen actually scored lower on cognitive function tests than subjects in the placebo group.

Researchers and drug companies would be overjoyed to announce that taking a standard, over-the-counter NSAID could prevent AD. It would become the instant best selling wonder drug of the 21st Century. And it would also cause widespread health havoc, because long-term use of NSAIDs prompts bleeding in the upper gastrointestinal tract while also increasing risk of heart attack and stroke.

Shortly after I sent you that May e-Alert, I came across this headline from Ivanhoe Newswire: “NSAIDs and Alzheimer’s: They All Reduce the Risk.”

Way to push those NSAIDs, Ivanhoe!

Yes, it seems that researchers had generally come to believe that ibuprofen offered greater AD protection than other NSAIDs. But when a Johns Hopkins team conducted a meta-analysis of six studies, they concluded that NSAIDs may provide modest AD prevention, but ibuprofen does not stand out as more effective.

Great! So we’re back were we started: Choose your poison – Alzheimer’s disease or a heart attack.

Put on protective headgear now

Jump ahead to June, and on the first day of the month HealthDay news very generously reported that Celebrex “may one day have value in helping to prevent lung cancer.”

In fact, this study only shows that a high dose of Celebrex (800 mg per day) might reduce levels of a biomarker that indicates lung cancer risk. Which is sort of like trying to stop a house fire by turning off a beeping fire detector.

In the Ivanhoe write up, researchers strike a balance between apple pie optimism and the not-so-optimistic reality that Celebrex might not actually turn off the biomarker, and even if it does, it probably won’t have any effect on lung cancer, and in any case, long-term use of Celebrex increases heart attack and stroke risk (as stated in a black box warning at the top of the drug’s prescribing information).

At a press conference, one of the authors of the study addressed the issue of using Celebrex to treat patients who already have lung cancer and said: “I hope we can keep you alive until you have a heart attack, because that means we have treated your lung cancer very well.”

No. He. DIDN’T!

Oh yes he did. If we can keep you alive until your heart attack, our work here is done.

Sources:
“Anti-Inflammatory Might One Day Help Prevent Malignancies, Study Suggests” HealthDay News, 6/1/08, nlm.nih.gov
“NSAIDs and Alzheimer’s: They All Reduce the Risk” Ivanhoe Newswire, 5/28/08, ivanhoe.com
“No Advantage of AB42-Lowering NSAIDs for Prevention of Alzheimer Dementia in Six Pooled Cohort Studies” Neurology, Published online before print 5/28/08, neurology.org