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Lewes, Delaware
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September 29, 2009     Cape Gazette
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September 29, 2009
 

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Cape Gazette HEALTH & FITNESS TUESDAY, SEPTEMBER 29 - THURSDAY, OCTOBER 1, 2009 23 II Arthritis drugs have hidden hazards heumatoid arthritis is a devastating disease. Besides crippling joints, it can leave the victim exhausted and in excruci- ating pain. Dm'ing the past sev- eral decades, drug companies have offered patients a Faustian deal: prompt pain relief with se- rious long-term consequences. In the 1950s, doctors pre- scribed cortisone-type drugs to reduce inflammation and allevi- ate pain. These medications were seen as wonder drugs. Pa- tients came into the office on crutches or in wheelchairs. Within a few weeks on drugs like dexamethasone, pred- nisolone or prednisone, they were walking again. It took many months or even years before side effects such as cataracts, glaucoma, weight gain, high blood pressure, muscle weakness, ulcers, irregular heart rhythms or diabetes showed up. Osteoporosis is another cata- strophic consequence of long- term, high-dose steroid use. We'll never forget the rheuma- tologist who told us that corti- costeroids melt bone. Many of these arthritis pa- tients felt betrayed when they discovered that their pain relief came at such a high price to their health. That's why nonsteroidal anti- inflammatory drugs (NSAIDs) became so popular. The very name implied that they were not as dangerous as steroids. Drugs like diclofenac (Voltaren), etodolac (Lodine), flurbiprofen (Ansaid), ibuprofen (Motrin), indomethacin (Indocin), keto- profen (Orudis), nabumetone (Relafen), naproxen (Naprosyn), piroxicam (Feldene) and sulin- dac (Clinoril) each had its mo- ment of glory. The only problem with NSAIDs is that they, too, have some serious side effects. They raise blood pressure, increase the risk for heart attacks and strokes, irritate the digestive tract and can result in bleeding ulcers. Other complications can include visual disturbances, ir- regular heart rhythms, kidney problems and ringing in the ears. It was estimated that more than 16,000 people died each year as a result of gastrointesti- nal bleeding triggered by 'NSAIDs (New England Journal of Medicine, June 17,1999). Fast-forward to the late 1990s and the introduction of biologic medications. Tumor necrosis factor (TNF) is a natural com- pound produced in the body. TNF blockers such as adali- mumab (Humira), certolizumab (Cimzia), etanercept (Enbrel), golimumab (Simponi) and in- fliximab (Remicade) were her- alded during that time period as miracles against rheumatoid arthritis. By affecting the immune sys- tem, such drugs were supposed to eliminate inflammation in the joints, slow or reverse the dis- ease process and prevent joint deformities. Many experts de- scribed these drugs as revolu- tionary, fundamentally altering the treatment of rheumatoid arthritis. It should not be surprising that the TNF blockers turned out to have some serious com- plications. The Food and Drug Administration has issued new warnings that these drugs can increase the risk of certain can- cers: lymphoma and leukemia. People who never had psoriasis may develop this skin problem when they stop the medicine. Because these drugs suppress the immune system, both bacte- rial and fungal infections may become life-threatening. Liver damage is another rare but very serious reaction. This history should lead pa- tients.and doctors alike to be cautious in looking for the next miracle cure for rheumatoid arthritis. Joe Graedon is a pharmacologist, and Teresa Graedon is a medical anthropologist. Write to them in care of King Features Syndicate, 888 Seventh Ave., New York, NY 10019, or at peoplespharmacy.com. THE RATE FOR 95%! and curing