Important note: Information in this article was accurate in 2004. The state of the art may have changed since the publication date.
Chicago Tribune - October 17, 2004
In an article released Oct. 7 by the New England Journal of Medicine, Dr. Garrett A. FitzGerald, an expert with a history of research in the cox-2 inhibitor class of medications, said cardiovascular problems seen with Vioxx may surface with the two other drugs. The problem, he said, is that all cox-2 inhibitors suppress the production of a heart-protecting fat called prostaglandin I2.
"Vioxx, Celebrex and Bextra all have the same effect on this biochemical system. Therefore, until proven otherwise, evidence would suggest that this mechanism would involve all drugs in this class," explained FitzGerald, who is chairman of pharmacology at the University of Pennsylvania's Institute of Translational Medicine and Therapeutics.
Dr. Steven Galson, acting director of the Food and Drug Administration's Center for Drug Evaluation and Research, said recently that cox-2 inhibitors other than Vioxx "do not have this same incidence of heart attack and stroke in clinical trials. There is a real difference in the data."
The brain on steroids
Giving steroids to reduce brain swelling can be deadly for patients with severe head injuries, according to the largest study on the subject.
The research, which included more than 10,000 patients treated at 239 hospitals in 49 countries, found that 21 percent of those who were given steroids died within two weeks, compared with 18 percent of those given a placebo. A report on the findings appears in the Oct. 9 issue of The Lancet.
The study was done because "if you looked at previous trials, use of steroids seemed pretty beneficial," said Dr. Ian G. Roberts, a professor of epidemiology at the London School of Hygiene and Public Medicine.
The original intent was to enroll 20,000 head injury patients for the study. The trial was cut short when evidence of damage emerged.
No U.S. hospitals were in the study, but "a lot of people use them" here, Roberts said.
HIV and counseling
Persuading HIV-positive young adults to avoid infecting others may lie in one-on-one counseling, a new study finds.
Counseling "equips them to make healthy choices in their life," said Lee Klosinski, director of programs at AIDS Project Los Angeles, which hopes to replicate the study's findings.
Researchers offered a choice of three infection-prevention programs to 175 HIV-positive young people in Los Angeles, San Francisco and New York.
The subjects, ages 16 to 29, were regular users of methamphetamine or intravenous drugs, and more than two-thirds were gay men. The participants, for the most part, had been very sexually active before the study. Some of the subjects had as many as 18 sessions with a counselor over the phone. Another group attended one-on-one sessions, while a third group was assigned to get counseling at a later date.
The study suggested that the one-on-one counseling convinced more than a third of participants to cut down on unprotected sex with partners whose HIV status was unknown. The telephone counseling wasn't as successful.
The findings appear in the October issue of the Journal of Acquired Immune Disorders.
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