Topical cream for Vioxx, Celebrex, and Bextra users

Since the recall of Vioxx and continued doubts about other Cox-2 drugs like Celebrex and Bextra (both of which may be recalled or required to have strong safety warning), other manufacturers of pain relief drugs for arthritis patients have started to talk now about their drugs. Their voices were drowned in the past due to the tens of millions of dollars spent on direct-to-consumer advertising by Merck and Pfizer. (Related article: Vioxx and Celebrex advertising to blame for deaths and injuries)

One such drug is called Pennsaid and it is a lotion, rather than an oral medication, used to treat pain and stiffness related to osteoarthritis. It combines diclofenac sodium, a widely used non-steroidal anti-inflammatory drug (NSAID), with a patented carrier. When spread on the skin, the lotion delivers direct pain relief while avoiding the inherent side effects of oral medications. Approved for use in Canada since 2003, Pennsaid is also available in the United Kingdom, Italy and the Caribbean. Pennsaid was invented in Canada and is not available in the United States yet. (Related article: Pain relief medication guide for Vioxx, Bextra, Aleve, and Celebrex patients)

The topically applied Pennsaid lotion has been proven to offer effective relief of pain and stiffness of osteoarthritis of the knee while offering a better overall safety profile than comparable oral medications. Three phase three clinical trials published in the Journal of Rheumatology, the Canadian Medical Association Journal and the Archives of Internal Medicine in recent months continue to drive awareness in the medical community of this medication which offers hope to those looking for a safe alternative to NSAID and COX-2 therapies.

The randomized, controlled 12-week trial in 622 patients with primary knee osteoarthritis published in the Journal of Rheumatology showed that Pennsaid was as effective as the maximum daily dose of comparable oral medication at relieving pain and stiffness, as well as improving the patients' assessment of overall well-being. The study also showed that applying Pennsaid led to fewer gastrointestinal-, renal- and liver-related side effects than oral medications.

The randomized, controlled, 4-week trial in 248 patients with primary knee osteoarthritis, published in the Canadian Medical Association Journal showed a 42 per cent reduction in pain, along with a 40 per cent improvement in stiffness and 30 per cent improvement in physical function following Pennsaid treatment.

The randomized, controlled 12-week study, which enrolled 326 patients with knee osteoarthritis published in the Archives of Internal Medicine, found that Pennsaid improved pain scores by 45.7 percent, physical function by 36.7 percent, and stiffness by 35.1 percent - a statistically significant difference over results from a control group that received the chemical carrier alone, minus the active drug. Two hundred and twenty-eight patients completed the study, and researchers measured the results using the same FDA-mandated standards applied to oral nonsteroidal anti-inflammatory drugs (NSAIDs), including COX-2 selective inhibitors.

Pennsaid efficacy is important to note since it is topically applied. The main problem with Cox-2 inhibitors like Vioxx, Celebrex, and Bextra is that these have to be taken orally and that is why they cause enormous harm to the body. Vioxx was recalled by Merck after it was proven that as many as 139,000 Americans are either dead or seriously injured. Celebrex and Bextra, both taken orally, also have adverse side effects and are currently under evaluation.

Recommended article: Celebrex, like Vioxx, should be recalled in the interest of safety