This One Medication Linked to an Estimated 88,000 to 139,000 Heart Attacks

Devi ShivaShanmi
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Why Vioxx Was Developed?  How Vioxx Works? What Went Wrong  The Approved Study and the Withdrawal of Vioxx Lessons Learned from the Story of Vioxx


In the late 1990s, pharmaceutical giant Merck released a new anti-inflammatory drug called Vioxx. Initially marketed as a safer alternative to other anti-inflammatory drugs, Vioxx was intended to block the pain-causing Cox-2 enzyme without causing stomach ulcers. However, it was later found to have deadly consequences, leading to Merck withdrawing the drug from the market in 2004. In this article, we will explore why Vioxx was developed, what went wrong, and what we can learn from this tragic story.


Why Vioxx Was Developed?


To understand why Vioxx was developed, we need to look at pain medications. Pain is a debilitating condition that has been the focus of extensive research for many years. Two primary classes of pain medications are opioids and anti-inflammatories. Opioids are highly effective at relieving pain but are also highly addictive and responsible for numerous deaths. Anti-inflammatories, on the other hand, are not addictive but are not as effective as opioids. Scientists have been trying to develop a medication that is both effective and not addictive, and that led to the development of Vioxx.


How Vioxx Works?


Vioxx was developed to block the Cox-2 enzyme, which creates inflammation that leads to pain. By blocking this enzyme, Vioxx was expected to relieve pain without causing stomach ulcers, which was a common side effect of other anti-inflammatory drugs. In 1999, Vioxx was approved by the FDA based on short-term studies that showed it was at least as effective as other anti-inflammatory drugs.


What Went Wrong: The Vigor Study


Merck wanted to prove that Vioxx was not only safe for long-term use but also effective for treating other medical conditions. To achieve this goal, they conducted a study called the Vigor study in 2000, which compared the gastrointestinal side effects of Vioxx to naproxen, a drug similar to ibuprofen. The study showed that Vioxx caused fewer gastrointestinal side effects than naproxen, which was good news for Merck. However, the study also showed that people taking Vioxx had twice the risk of heart attack or stroke. Merck tried to explain this away by claiming that naproxen had a protective effect against heart attack and stroke, which was untrue. They also claimed that the risk was only elevated in people with known heart disease, which was later proven to be false.


The Approved Study and the Withdrawal of Vioxx


In 2004, a study approved by the FDA showed that Vioxx carried twice the risk of heart attack or stroke compared to a placebo. Merck argued that this only happened after 18 months of usage, but they had no choice but to withdraw Vioxx from the market. However, the damage had already been done. Over 20 million people had already taken Vioxx, leading to an estimated 88,000 to 139,000 heart attacks, of which 30 to 40 percent were fatal.


Lessons Learned from the Story of Vioxx


The story of Vioxx highlights several important lessons. Firstly, we must be cautious of all studies where the manufacturer has a vested interest. Secondly, we need to be aware of the potential long-term effects of new medications. Thirdly, we must have systems in place to detect and address any safety concerns promptly. It is essential to put patient safety above all else and to remember that the consequences of not doing so can be deadly.

How this medication killed 60,000 people and no one went to jail


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