|
medpundit |
||
 |
 |
|
Friday, December 27, 2002Celebrex is one of the newer arthritis medications that is supposed to have a lower incidence of stomach upset and ulcers than the older arthritis drugs like ibuprofen or aspirin. The study compared the incidence of ulcers in people who used Celebrex alone compared to people who used diclofenac (brand name Cataflam or Voltaren), an older arthritits drug, paired with an ulcer prevention drug, omeprazole (brand name Prilosec). The dose of Celebrex in the study was 200 mg twice a day. That costs $148 a month. The dose of diclofenac was 75 mg twice a day, which costs $27 a month for the generic version. Add omeprazole, and you add another $99 a month to the price tag, for a total of $126 a month. So, just what did they find? That the two treatments were comparable: In the intention-to-treat analysis, which included 287 patients (144 receiving celecoxib and 143 receiving diclofenac plus omeprazole), recurrent ulcer bleeding occurred in 7 patients receiving celecoxib and 9 receiving diclofenac plus omeprazole. The probability of recurrent bleeding during the six-month period was 4.9 percent (95 percent confidence interval, 3.1 to 6.7) for patients who received celecoxib and 6.4 percent (95 percent confidence interval, 4.3 to 8.4) for patients who received diclofenac plus omeprazole (difference, –1.5 percentage points; 95 percent confidence interval for the difference, –6.8 to 3.8). Renal adverse events, including hypertension, peripheral edema, and renal failure, occurred in 24.3 percent of the patients receiving celecoxib and 30.8 percent of those receiving diclofenac plus omeprazole. So, Celebrex may not be any better than the cheaper and older therapy when it comes to ulcer risk, but only if that cheaper and older therapy is taken with an anti-ulcer pill. Unfortunately, the addition of that anti-ulcer pill makes the regimen only marginally less expensive than Celebrex alone. There's another concern about using two drugs when one will do. The more drugs ingested, the greater the risk of side effects and drug-to-drug interactions. Omeprazole interacts with a long list of other drugs. So do Voltaren and Celebrex. In the end, it’s always best to try to simplify a medical regimen as much as possible and avoid using two drugs when one would do just as well. If the $20 a month difference is going to strain the pocket book, then by all means the cheaper combo would be fine, but otherwise, the one drug regimen of Celebrex would be the better choice. posted by Sydney on 12/27/2002 08:13:00 AM 0 comments 0 Comments: |
|
