Prexige and arthritis

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

The selective COX-2 inhibitor lumiracoxib (Prexige, Novartis) was approved for use in the UK.

It was originally approved two years ago but hadn't been launched because the company was waiting for the results of a large clinical trial. Novartis then until the European Medicines Evaluation Agency (EMEA) finished its review of the whole coxib class of medicines after the Vioxx fiasco.

Lumiracoxib is indicated for the symptomatic treatment of osteoarthritis (OA) (at a recommended dose of 100 mg once daily), for the short-term management of acute pain associated with primary dysmenorrhea (at a recommended dose of 200 mg daily for a maximum of three days per menstrual cycle), and for acute pain following orthopedic or dental surgery (at a recommended dose of 400 mg once daily for a maximum of five days).

The new product has efficacy comparable to products already on the market but offers an advantage in terms of its gastrointestinal (GI) toxicity profile. Lumiracoxib is the cheapest selective COX-2 inhibitor for use in osteoarthritis on the UK market—the cost of treatment for 30 days with 100 mg is $50.00, which is 20% less than celecoxib (Celebrex, Pfizer), the first coxib to be launched.

Many rheumatologists feel that anti-inflammatory drugs should not even be considered until patients have tried all the non-pharmacologic measures (weight loss, muscle-strengthening exercises, physical therapy, walking aids, appropriate footwear, etc) and also tried analgesics (eg, acetaminophen alone or in combination with codeine). Non-steroidal-anti-inflammatory drugs (NSAIDs) carry the risk of serious side effects, including gastrointestinal, kidney, and cardiovascular events.

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