NSAIDs and COX-2s equal for arthritis

WASHINGTON, Oct. 9 (UPI) -- Two common osteoarthritis drugs provide the same level of pain relief and create the same risk of heart and kidney problems, according to U.S. researchers.

A new government study came to that conclusion after a review of 360 published studies on osteoarthritis medications.

The Health and Human Services' Agency for Healthcare Research and Quality concluded that non-steroidal anti-inflammatories (NSAIDs) and COX-2 inhibitors (a newer generation of NSAIDs) relieved pain equally well and also caused or worsened an equal number of heart attacks and cases of high blood pressure, congestive heart failure, edema, impaired kidney function and gastrointestinal distress.

The exceptions were the NSAIDs naproxen (also called Aleve or Naprosyn), which produces fewer heart attacks, and acetaminophen, which reduces pain less effectively but causes less gastrointestinal distress.

NSAIDs, which include aspirin, ibuprofen, acetaminophen, Motrin, Advil, Clinoril, Voltaren, Cataflam, Aleve and Naprosyn -- suppress two related enzymes that cause inflammation, one of which also helps maintain kidney function and protects the stomach lining from digestive chemicals.

COX-2 inhibitors (Celebrex, Vioxx, Bextra) target the first enzyme but don't suppress the one essential for the kidneys and stomach.

Neither class of drug works against rheumatoid arthritis, an autoimmune disorder that can strike at any age. Osteoarthritis is produced by a loss of cartilage between the joints that allows bones to rub together and is associated with aging and trauma.

The new report -- called Comparative Effectiveness and Safety of Analgesics for Osteoarthritis -- is available at http://effectivehealthcare.ahrq.gov/synthesize/reports/final.cfm.