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Pri-Med Notes Physician Confidence in COX-2 Inhibitors Registers Sharp Decline

Posted on: Thursday, 23 June 2005, 15:00 CDT

Majority of Primary Care Physicians Believe Drugs Class Remains Important Treatment for Chronic Pain in Some Patients

In the wake of the withdrawal of Vioxx and Bextra from the market, fewer than one in five primary care physicians plan to prescribe COX-2 Inhibitors for treating chronic pain according to a nationwide survey by Pri-Med Institute. COX-2 Inhibitors were first associated with thousands of deaths from heart attacks and strokes in November 2004, when Vioxx was withdrawn voluntarily by Merck & Co. Bextra, a Pfizer product, was withdrawn by the FDA in April 2005, due to rare, serious skin reactions and heightened cardiovascular risk.

Despite the negative publicity, the Pri-Med Institute survey found that three out of four primary care physicians believe that the COX-2 Inhibitor drug category remains an important option in treating severe chronic pain in patients who do not have pre-existing heart conditions or hypertension. Almost half of those surveyed believe Vioxx should be returned to the market, and one in two feel confident in prescribing new COX-2 Inhibitor formulations currently in clinical trials.

Only half of the doctors surveyed believe that over-the-counter medications are as effective in treating chronic pain in conditions like osteoarthritis and rheumatoid arthritis. However 75% believe that COX-2 Inhibitors have an important role in providing greater protection to patients at risk for severe and sometimes life-threatening gastric bleeding associated with long-term use of NSAIDs.

"The picture that emerges is one in which a majority of primary care physicians continue to believe that the COX-2 Inhibitor drug category presents important treatment options for patients who do not have cardiovascular disease or hypertension, " Anne Goodrich, Pri-Med Institute director of research, said. "While almost two out of three physicians believe that over-the-counter NSAIDs are as effective for most patients, COX-2 Inhibitors are perceived as treatments for which there is no effective substitute in treating severe chronic pain in patients at risk for gastric bleeding."

A principal reason for ceasing the use of COX-2 Inhibitor drugs, cited by 86% of respondents, is patient apprehension in the wake of widespread media attention to their risks.

"Intense media scrutiny has clearly caused patients who formerly used Vioxx or Bextra to press for alternative treatments," Tracy Webb, Ph.D., Pri-Med Institute clinical editor said. "But there remains a patient population for whom no effective alternative to COX-2 Inhibitors is available today."

Information provided by the Pri-Med. It is Pri-Med's goal to advance the practice of medicine and outcomes of care for patients. Pri-Med is committed to researching the needs, attitudes and behaviors of the nation's clinicians as a crucial step toward providing superior quality continuing education that is evidence-based, and clinical management strategies that are innovative in design and motivate physicians to adopt appropriate, up-to-date clinical practices.

Source: Business Wire

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