September 30, 2004 - The Food and Drug Administration (FDA) today acknowledged
the voluntary withdrawal from the market of Vioxx (chemical name rofecoxib),
a non-steroidal anti-inflammatory drug (NSAID) manufactured by Merck & Co.
FDA today also issued a Public Health Advisory to inform patients of this action
and to advise them to consult with a physician about alternative medications.
Merck is withdrawing Vioxx from the market after the data safety monitoring
board overseeing a long-term study of the drug recommended that the study be
halted because of an increased risk of serious cardiovascular events, including
heart attacks and strokes, among study patients taking Vioxx compared to patients
receiving placebo. The study was being done in patients at risk of developing
recurrent colon polyps.
"Merck did the right thing by promptly reporting these findings to FDA
and voluntarily withdrawing the product from the market," said Acting FDA
Commissioner Dr. Lester M. Crawford. "Although the risk that an individual
patient would have a heart attack or stroke related to Vioxx is very small,
the study that was halted suggests that, overall, patients taking the drug chronically
face twice the risk of a heart attack compared to patients receiving a placebo."
Dr. Crawford added that FDA will closely monitor other drugs in this class
for similar side effects. "All of the NSAID drugs have risks when taken
chronically, especially of gastrointestinal bleeding, but also liver and kidney
toxicity. They should only be used continuously under the supervision of a physician."
FDA approved Vioxx in 1999 for the reduction of pain and inflammation caused
by osteoarthritis, as well as for acute pain in adults and for the treatment
of menstrual pain. It was the second of a new kind of NSAID (Cox-2 selective)
approved by FDA. Subsequently, FDA approved Vioxx to treat the signs and symptoms
of rheumatoid arthritis in adults and children.
At the time that Vioxx and other Cox-2 selective NSAIDs were approved, it was
hoped that they would have a lower risk of gastrointestinal ulcers and bleeding
than other NSAIDs (such as ibuprofen and naproxen). Vioxx is the only NSAID
demonstrated to have a lower rate of these side effects.
Merck contacted FDA on September 27, 2004, to request a meeting and to advise
the agency that the long-term study of Vioxx in patients at increased risk of
colon polyps had been halted. Merck and FDA officials met the next day, September
28, and during that meeting the company informed FDA of its decision to remove
Vioxx from the market voluntarily.
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