Dr Trevor Mudge, AMA Vice President, Radio 5DN, with Jeremy Cordeaux
CORDEAUX: If you take medication for arthritis, make sure you listen carefully to this. The American Medical Association has published findings which claim that two of the major drugs for controlling arthritis can actually be dangerous to some patients. The drugs are Celebrex and Vioxx, they have been described … or prescribed to an estimated one point five million Australians, but Americans say that for people with a history of heart disease the drug could trigger blood clots or heart attacks. It's a disturbing thing to hear. We need to make sure that these drugs, when they are prescribed, have been thoroughly checked. That's not to say these haven't been checked, but here's something that's sort of come out left field.
Trevor Mudge is the Vice President of the Australian Medical Association. Thank you for your time, Doctor.
MUDGE: You're welcome, Jeremy.
CORDEAUX: What can you tell us about these two drugs?
MUDGE: Well, there isn't a drug known to man that isn't prone to have some side effects or some potential downsides. As far as we can tell, these drugs are, as has been said, remarkably safe. They've been … twenty million people, around the world, taking Celebrex, for example. And one of the reasons that it's such an expensive drug, like all new drugs on the market now, we, in society demand a very high standard of investigation of these drugs before they're able to be sold, and indeed what we call post-marketing surveillance. Once they're on the market, adverse events have to be reported, too.
CORDEAUX: Well, when we…
MUDGE: If twenty million people take it, it wouldn't be surprising if some of those twenty million died from heart disease.
CORDEAUX: Mm.
MUDGE: … because it's our biggest killer.
CORDEAUX: But a journal like the Journal of the American Medical Association would kind of take that statistic into balanced consideration.
MUDGE: Yeah, absolutely. The reported increase in heart, poor heart disease outcomes, is very small. It's of the order of point one percent in the published figures. Now, very small variations are statistically very difficult to prove and require very big studies. It may well be true. After all, we know that if you live in Mount Gambier you're more likely … sorry … you live in Adelaide, you're more likely to die of lung cancer than if you live in Mount Gambier. But, as with all lifestyle choices, it's not a big enough difference to make us all move to Mount Gambier. So that everyone has to weigh the risk and benefit of everything they do in life. Nothing is without risk. Walking in the supermarket, clearly, is not without risk.
CORDEAUX: But you don't …
MUDGE: …… benefits and side effects. Breathing exercises are going to help some people with asthma, but they're not going to replace drugs. Drugs for asthma and a good asthma plan with your doctor saves lots of lives.
CORDEAUX: I suppose, with some media reports that have been around of late, we can't be blamed for being a little bit cynical about the fact that drug companies are businesses, and they resort to all kinds of marketing tricks to put pressure on you doctors to prescribe a drug, where maybe you could be prescribing something different.
MUDGE: Yeah, sure. But, by the same token, we, all of us, depend on big, rich pharmaceutical companies to develop new drugs which save lives, and to test those drugs before they come on the market so that if there is an increased risk of heart disease it's the order of zero point one percent and not of the order of fifty percent.
CORDEAUX: A caller off air reports that her husband died four days after starting to take Vioxx. He got a thrombosis, died at the age of fifty-eight.
MUDGE: As I said, the chance of somebody dying in their fifties, in the age group at which they take Celebrex, is not insignificant. Coincidentally, it's not necessarily cause and effect. That's why you need very big studies, and that's why those studies are done, and that's why the drugs are expensive.
CORDEAUX: Mm. Trevor, thanks for your time again.
MUDGE: You're welcome, Jeremy.
CORDEAUX: All the best.
Ends