Dr. Eric J. Topol of the Cleveland Clinic argued Tuesday in the online edition of the Journal of the American Medical Association that the heart-attack risks of arthritis painkillers Vioxx, Bextra and Celebrex have exposed a regulatory "house of cards" at the Food and Drug Administration.

"Unbridled promotion exacerbated the public health problem," Topol said. "The combination of mass promotion of a medicine with an unknown and suspect safety profile cannot be tolerated in the future."

FDA officials have not publicly addressed the issue of whether high-powered advertising campaigns for newly approved drugs are in the best interest of public health.

Other leading academic researchers have suggested that new drugs should be subject to a trial period before they can be touted directly to patients.