Confusion reigns in the post-Vioxx musculoskeletal pain market

A new global survey of primary care physicians (PCP) and people with chronic musculoskeletal pain reveals continuing confusion about the safety of COX-2 selective (coxibs) and non-selective non-steroidal anti-inflammatory drugs. As a result, about half of chronic pain sufferers eschew analgesia altogether and in half of cases, do so on the advice of PCPs.

Arthritis Action Group, comprising physicians of various specialties and academics, presented results of "Insights into Pain Relief" in Amsterdam, the Netherlands during the annual European League Against Rheumatism meeting. The survey of 1,204 musculo-skeletal pain sufferers and 604 PCPs in six countries, excluding the USA, revealed that up to 47% of people with chronic joint pain now use no medication at all, with up to 25% citing worries about side effects and around 22% saying their doctor advised stopping use of their drugs. Almost two thirds of patients were confused by conflicting information about prescription and over-the-counter pain-relief medicines and felt they did not know enough about risks and benefits.

They are not the only ones. Many physicians are equally confused. In the two years since Merck & Co withdrew its coxib Vioxx (rofecoxib) worldwide, the US Food and Drug Administration has asked Pfizer to withdraw Bextra (valdecoxib) and slapped a black-box warning of cardiovascular risk on all NSAIDs and coxibs.