The withdrawal of pain medications Vioxx and Bextra from the market affected many arthritis sufferers who had been getting tremendous pain relief from the drugs. But the pharmaceutical companies had little choice; a significant number of people developed heart problems while taking the popular anti-inflammatories.

Recent research by two Winthrop doctors suggests an explanation for the increased risk of heart attacks among users of these drugs and others in a class known as COX inhibitors. The Winthrop research also suggests a potential way to eliminate or reduce the cardiovascular risks while retaining the benefits of these medications. The Winthrop research team included Allison Reiss, MD, Head of the Inflammation Section of the Vascular Biology Institute at Winthrop, and Steven Carsons, MD, Chief of Winthrop's Division of Rheumatology, Allergy and Immunology.

"Prior to the completion of this research project, the prevailing theory to explain the increase in heart attacks in Vioxx users and others had been that the COX inhibitor drugs encouraged clot formation," said Dr. Reiss. But this group embarked on a research project that showed that in fact the drugs impaired the ability of cells to rid themselves of excess cholesterol.

Next, the researchers sought ways to overcome the unhealthy effects without destroying the pain-relieving benefits of the drugs. The team found that by adding certain chemicals that occur naturally in the body and which are reduced by treatment with COX drugs, they could restore an appropriate cholesterol balance while retaining the pain-relieving benefits. This suggests a promising approach for future studies as new drugs are developed to treat pain.

The research, which was done in collaboration with Dr. Edwin Chan of the Division of Clinical Pharmacology at NYU School of Medicine, was published in the journal Arthritis Research and Therapy.