Do you need painkillers every day? Biestmilch protects your stomach

Just a few days ago I found the results of a huge field study on anti-inflammatory drugs like Diclofenac, famous voltaren (COX-I/COX-II) and COX-II big deal Vioxx, published in Nature* under the following title:

Review uncovers new killer drug
Common painkiller may induce heart attacks

A widely-used medicine may confer cardiovascular risks as serious as those found with Vioxx, an arthritis medicine that was withdrawn from the market two years ago.
Diclofenac, an older non-steroidal anti-inflammatory drug (NSAID)**, has been on the market for decades and is one of the most-widely prescribed anti-inflammatories in the world — especially in Europe. At commonly prescribed doses, it was found to increase the risk of cardiovascular events — primarily heart attack and sudden death — by 40%.
The meta-analysis, published by the Journal of the American Medical Association, looked at 23 studies involving some 1.6 million people.

Not everyone agrees. "Our view is that this meta-analysis is incomplete… ," says a spokesperson for Novartis in Basel, Switzerland. Novartis markets diclofenac under the trade name Voltaren.
The study authors — Patricia McGettigan of the University of Newcastle in New South Wales, Australia, and David Henry of Newcastle Mater Hospital in Waratah, New South Wales — call for a review of the regulatory status of diclofenac (e. g. Voltaren).
Merck, on the other hand, is currently using diclofenac as a comparison drug in a trial
of Arcoxia, a next-generation cox-2 inhibitor developed to succeed
Vioxx for arthritis patients. Researchers question the study design already, Merck refutes already. Business as usual.

Regardless all the usual controversies between pro and con, I think this report makes it very obvious how problematic painkillers can be. But it’s all very well to say that, if you are in need of them, if you suffer from arthritis or painful never ending sports injuries, and if you don’t want to risk your job than one might prefer to take the health risk.

Beside the increased cardiavascular risk, it is well-known that non-steriodal anti-inflammatory drugs harm the mucosal lining of your stomach. Gastrointestinal bleeding und ulcers are therefore no rare incidents. In 2001 Playford et al. carried out a study with bovine colostrum/biestmilch to examine its effect on on the gastro-intestinal surface. The result clearly showed the protective effect of biestmilch. The normally increased permeability of the stomach’s epithial layer under NSAIDs was significantly reduced. This implies that the damaging gastric acid cannot reach the tissue underneath that easy and harm it. Henceforth, if your are obliged to take NSAIDs, consider the fact that biestmilch can prevent these side-effects.
And moreover, the regulatory impact of biestmilch on the immune system may also positively affect cardiovascular problems which are basically a chronic inflammatory origin as well.

*Published online: 12 September 2006; Updated online: 13 September 2006

Standard NSAIDS**, such as ibuprofen or naproxen, work to relieve pain by
blocking one form of the cyclooxygenase enzyme — cox-2 — at sites of
tissue injury. But because they also work on another form, cox-1, which
is found in the gut, they also often damage the gastrointestinal tract.
A new generation of drugs, selective for cox-2 alone, were created with
the hope of easing pain without damaging the gut.

Vioxx (rofecoxib) is one of these drugs. But Vioxx was withdrawn from
the market after studies showed that it substantially increased the
risk of heart attack and other serious cardiovascular events. The new
JAMA study confirms these earlier findings, showing that the risk is
dose-related (more than doubling at high doses), begins immediately and
is elevated in the first month of use.

But Vioxx may be unique in its class in the extent to which it causes
these side-effects. Steve Nissen, a cardiologist at the Cleveland
Clinic who is running a separate trial that includes Celebrex (a
chemical cousin of Vioxx and a common cox-2 inhibitor), says that the
JAMA study hints that Vioxx is an outlier. "It looks like it’s really a
problem with one or two drugs but not all of them," he says. This opens
the possibility that other such NSAIDs will be safe, even if Vioxx is
not.

The study suggests that Celebrex (celecoxib) is not harmful to the heart at the commonly used dose of 200 mg, but seems to be unsafe at doses of 400 mg or more.

For the future, researchers are aiming to find a class of anti-inflammatories that will both be kind to the stomach and to the heart. Research released by the Proceedings of the National Acadamy of Sciences this week shows promising news of a drug target, found in a mouse model, that slows the development of atherosclerosis. This might help a new class of ‘super NSAIDs’ not only steer clear of heart disease risk but work to reduce it.

In the meantime, the JAMA study may cause problems for Merck. The company is currently using diclofenac as a comparison drug in a trial of Arcoxia, a next-generation cox-2 inhibitor developed to succeed Vioxx for arthritis patients. Merck spokesperson Christopher Loder says that the company stands by their choice of diclofenac for this trial.