COX-2 inhibitors / endolethial function
By Maggie Fox, Health and Science Correspondent
WASHINGTON, Jan 13 (Reuters) - Anti-inflammatory drugs used to treat arthritis may also reduce the risk of heart disease by keeping the arteries limber, Swiss researchers said on Monday.
Their findings add to a growing body of research that suggests inflammation plays an important role in heart disease -- perhaps as important as a fatty diet.
Still under debate is what causes the inflammation -- an infection of some sort, or perhaps the way the body deals with too much fat in the blood. But drugs designed to reduce inflammation do seem to help against heart disease.
Studies aimed at finding out why are spotty at best, said Dr. Frank Ruschitzka, a cardiologist at University Hospital in Zurich, Switzerland.
He tested 14 of his patients, giving all of them their standard lipid-lowering drugs, blood-thinning aspirin and other medications. For two weeks, half got Celebrex on top of everything else and half got a dummy pill. Then he swapped the two groups.
Celebrex, known generically as celecoxib and marketed by Pharmacia (NYSE:PHA) and Pfizer (NYSE:PFE - News), is a member of a new class of drugs called COX-2 inhibitors. They work in the same way as aspirin, ibuprofen and other so-called non-steroidal anti-inflammatory drugs or NSAIDS, but supposedly without some of the side-effects such as stomach bleeding.
It would take years to tell whether taking COX-2 inhibitors reduced the risk of heart disease, so Ruschitzka and colleagues instead measured markers of heart disease, such as endothelial function -- a measure of how efficiently blood vessels are working -- levels of C-reactive protein, which is associated with both inflammation and heart disease, and levels of the fat that blocks arteries -- oxidized low-density lipoprotein.
All three improved while the patients were on COX-2 inhibitors, the researchers report in this week's issue of the journal Circulation.
"The increase which we have seen we is well within the range of what we have seen in other cardiovascular medications such as statins and ACE inhibitors," Ruschitzka said in a telephone interview.
"There are only a few drugs out there that improve endothelial function. This is not a small increase."
Ruschitzka, who said his study was not funded or directed by any drug company, said more and bigger studies need to be done before heart patients are advised to add anti-inflammatory drugs to their regimens.
"What we clearly see is that atherosclerosis (hardening and clogging of the arteries) is an inflammatory disease," he said. It is caused not only by the deposition of cholesterol stuff. There is inflammation going on."
Doctors have been onto this idea and are studying whether perhaps the inflammation is caused by infection of some sort.
Results are mixed, although some studies have suggested that taking antibiotics may reduce the risk of heart disease. But there are many different antibiotics that work against different bacteria and no one has zeroed in on the right target.
"Inflammation and infection may be two different stories. Inflammation may be caused by non-infectious agents," Ruschitzka said.
For instance, immune cells often try to pull particles of fat out of the blood. They engulf the particles, becoming what are known as foam cells, and sometimes get caught in blood vessel walls. This process can cause inflammation... |
