Vioxx Case Illustrates Dual Nature of Drugs

There is increasing evidence that not just Vioxx but similar drugs, like Celebrex, or celecoxib; and Bextra, or valdecoxib, both made by Pfizer, might increase the risk of heart problems. But the risks of Vioxx and Celebrex came to light only because they were tested in long-term studies to see if they could prevent cancer.

Instead, because an independent board overseeing the study had reported that Vioxx, whose generic name is rofecoxib, was associated with a twofold increase in heart attacks and strokes, an unacceptable risk for otherwise healthy people, Merck announced on September 30 that it was halting the 2,000-patient study. It withdrew Vioxx from the market and stopped all other studies that asked if the drug could prevent cancer.

The company says it has no plans to bring the drug back.

Bresalier, a professor and chairman of the department of gastrointestinal medicine and nutrition at M.D. Anderson Cancer Center in Houston, explained the polyp results had emerged in data analyses only a few weeks ago, showing the study was "substantially positive." He has not yet presented the results to other scientists for review. The study was paid for by Merck.

Now, the mixed news about Vioxx raises questions of risk and benefit that science simply cannot answer.

There is increasing evidence that not just Vioxx but similar drugs, like Celebrex, or celecoxib; and Bextra, or valdecoxib, both made by Pfizer, might increase the risk of heart problems. But the risks of Vioxx and Celebrex came to light only because they were tested in long-term studies to see if they could prevent cancer. And if drugs like this do prevent cancer, which risk is worse, cancer if you do not take them, or heart attacks if you do? Who decides?