Side effects create pain for professor’s discovery

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    By Emilie Foss

    A BYU professor played a major role in the development of arthritis pain medications, which are under investigation for causing heart attacks and strokes.

    Daniel Simmons, professor of chemistry and biochemistry, discovered the enzyme Cox-2 in a Harvard laboratory while doing his post-doctorate research in 1989.

    ?I was ecstatic, very excited, right from the beginning I knew it was a very important discovery,? Simmons said.

    The Cox-2 enzyme is involved with the synthesis of prostaglandins, potent hormone like substance that are produced in various mammalian tissue, and plays a major role in pain and fever.

    To help alleviate arthritis pain, medications, Vioxx, Celebrex and Bextra were developed and Cox-2 is essential inhibitor in these medications.

    Simmons helped Searle, a pharmaceutical company, get started on their project Celebrex and Bextra. Another company, Merck, developed Vioxx. They learned of Cox-2 through reading the literature of Simmons? discovery.

    ?It was nice to use Vioxx because patients only had to take a pill once a day rather than six to seven times taking a pain medication,? said Dr. James Pingree, a Salt Lake City general surgeon.

    These medications have allowed for arthritis patients to live more normal lives, such as going out in the cold weather, when they normally would not be able to do so.

    ?I get aches and pains in my joints, and I cannot walk very long distances,? said Allie Rawlins, 19, a political science major at North Idaho College, who took Vioxx for two ? years.

    However, last September Vioxx was pulled off shelves worldwide because of controversies that it is the cause of heart attacks and strokes. Celebrex and Bextra are currently under scrutiny. The FDA has not yet involved Simmons in the investigation.

    In the first study of Vioxx, Merck noted the cardio vascular problem but was not certain if Vioxx and other aspirin-like drugs were the cause of true cardio vascular problems. Now it is clear that Vioxx is the cause of the heart attacks.

    ?All this business of taking it off the market is really extreme,? Dr. Pingree said. ?It?s too bad it came up with side-effects because for the majority of people it was great, but for a few people who had been taking it a long time it was dangerous.?

    Some physicians find this a difficult position.

    ?It?s a little bit frustrating because the most common reason that patients go to see doctors is because of pain and now there is one less thing to prescribe,? said Dr. Richard Thurman, a Provo physician.

    Dr. Pingree understands this problem because now all he can prescribe is Celebrex and Bextra, which could possibly be taken off the market as well.

    ?The only medication I take now is Motrin, because of the dangers with the side-effects of Vioxx,? Rawlins said. ?I am disappointed that it doesn?t give me the relief I used to get with Vioxx.?

    Professor Simmons said if Celebrex and Bextra evidence shows that these drugs cause heart attacks and strokes than older drugs like ib profen, Naproxem and Aleve, testing will be done to see if they cause heart attack problems as well.

    ?We don?t know a lot about the old drugs or what their dangers are because they have never been tested,? Simmons said.

    The FDA will conduct a meeting Feb. 16 to take a hard look at the Cox-2 selected drugs. In this meeting, the FDA will be gathering information and then will develop guidelines for aspirin-like drugs.

    ?You need a crystal ball to tell what will happen with all of this,? Simmons said.

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