COX-1 Drugs Versus COX-2 Drugs
Up until the 1990s the non-steroidal anti-inflammatory drugs (NSAIDs) that blocked both COX-1 and COX-2 enzymes equally were the primary drugs of choice for pain relief. These non-selective NSAIDs, however, had numerous side effects, particularly when taken over extended time periods. Patients with arthritis and other inflammatory ailments were taking these drugs three to five times a day, over decades. The patients suffered from considerable side effects, the most notable of which included stomach irritation, ulcers and intestinal bleeding.
After the discovery of two types of COX enzymes, research was conducted to determine if one of the enzymes was responsible for these side effects. The hope was that by developing a drug that would block the COX enzymes responsible for stomach functioning, then a pain relieving drug could be developed that would not have the gastrointestinal side effects.
COX-1 or COX-2: Which to Block?
By the mid 1990s research data began to suggest that COX-1 enzymes were responsible for proper functioning of the stomach and intestinal lining. Specifically, it was discovered that COX-1 enzymes were more involved in everyday "housekeeping" in the body, and were present all the time. These enzymes constantly circulated throughout the body to keep all body processes working in harmony.
One mission of the COX-1 enzymes is to insure that the stomach lining and other parts of the digestive tract are functioning well. COX-2 enzymes, on the other hand, were thought to be produced by the body primarily when inflammation and swelling was present. These enzymes were found to increase 20-fold in areas of the body where damage or injury has occurred.
These findings lead researchers to believe that COX-2 enzymes were primarily associated with pain and COX-1 enzymes served other "maintenance" purposes. Researchers believed a drug that blocked COX-2, without affecting COX-1 enzymes, could become a pain reliever with a promise: No gastrointestinal side effects of non-selective NSAIDs.
Now We Know: A Balance is Needed
Unfortunately, researchers were incorrect. COX-1 and COX-2 enzymes both play very important roles throughout the body. Blocking only one of the enzymes has devastating effects. Furthermore, data suggests that COX-1 and COX-2 enzymes each serve as a "check and balance" for one another. If one type of COX enzyme is reduced too much in the body, the other type could create a very dangerous imbalance. This dangerous imbalance presumably is what has lead to heart attacks, strokes, blood clots, and other cardiovascular side effects linked to Vioxx use.
Evidence suggests that the manufacturer of Vioxx, Merck Pharmaceuticals, knew of the dangerous side effects of Vioxx but failed to warn physicians and patients in a timely manner. This failure might make Merck financially liable for any suffering sustained by patients who took Vioxx. If you have developed cardiovascular symptoms after taking Vioxx, please contact a skilled personal injury attorney to find out if compensation might be available. Because health tragedies, such as those brought about by Vioxx ingestion, often destroy family lives, many Vioxx attorneys recommend that their clients also consult legal professionals specializing in family law. In addition, some Vioxx victims require the help of a considerate divorce lawyer and/or DWI lawyer.