New data from a clinical trial found an increased risk of heart attack and stroke, mirroring the results of numerous other 2004 studies that showed similar increased risks of heart attack and stroke. Merck spokesmen Thursday said data from the trial showed heart attack risks and other cardiovascular complications surfaced in patients 18 months after starting Vioxx.

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Merck is the world's third-biggest drug maker. Vioxx sales totaled $2.55 billion worldwide in 2003. In the United States alone, 91 million Vioxx prescriptions have been written. Vioxx is currently used by two million people worldwide and over 84 million people have used the medication since its introduction in 1999.

Vioxx is part of a class of anti-inflammatory drugs called cox-2 inhibitors. Cox-2 inhibitors are heavily touted by the pharmaceutical industry as being more effective with less side effects than older arthritis drugs.
However; "In terms of pain relief, these drugs are no better than ibuprofen and they cost 10, 15 times more," said independent health care analyst Hemant Shah of HKS & Co. in Warren, N.J. Shah also said physicians prefer ibuprofen more than Celebrex and Vioxx combined.

Heart attack and other heart complications have been a looming concern for Vioxx and other Cox-2 inhibitors.

According to a large study financed by the FDA, patients taking Vioxx had a 50 percent greater chance of heart attack and sudden cardiac death than individuals using Celebrex. The 2004 study also found patients taking the highest recommended daily dosage of Vioxx had three times the risk of heart attack and sudden cardiac death as those not taking standard painkillers.

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Researchers, after analyzing the medical records of 1.4 million people insured by Kaiser, found that 8,199 heart attacks and cases of sudden cardiac death occurred between 1999 and 2001 among patients taking Vioxx.
Canadian researchers in May (2004) reported an increased risk for heart attack and heart disease among elderly people using Vioxx that wasn't noted in those taking its rival, Celebrex. This study, published in “The Lancet,” reported that those taking Vioxx were 80 percent more likely to be admitted to the hospital with heart attack and heart problems.

Researchers at the Arthritis Research Center Foundation examined data on 8,500 patients. Patients taking Vioxx were 21 percent more likely to develop the heart problem of high blood pressure and 23 percent more likely to develop leg swelling than those taking Celebrex. This study was published in the June 2004 issue of the “Journal of Rheumatology.”

Although most of the heart attack focus has been connected with Vioxx, the withdrawal of Vioxx casts a cloud over the entire class of widely used COX-2 inhibitors.
An article in the August 2004 issue of the "Journal of the American Medical Association" reanalyzed old data to suggest that there might be heart attack problems with not only Vioxx but also with Celebrex.

Both the FDA and Merck have advised patients taking Vioxx to consult their physician about alternative medications.

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