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August 21, 2005

Q&A: Vioxx Lawsuit

Vioxx
Vioxx was withdrawn from sale in September 2004

US pharmaceutical giant Merck has been ordered to pay $253.4m (£141m) to the widow of a man who died from a heart attack blamed on the popular painkiller Vioxx. The BBC News website answers key questions about the case and about what happens next.

Q: What is Vioxx?

Vioxx is the trade name for rofecoxib, a type of painkiller known as a Cox-2 inhibitor.

The drug was sold around the world in the late 1990s. In all it was taken by about 20m people, including 400,000 in the UK.

It provided pain relief, mainly for arthritis sufferers, without the side-effects of stomach problems which can be triggered by aspirin and other types of painkillers.

But research then uncovered side-effects of a different sort. Experts concluded that an entire class of Cox-2 inhibitors significantly raised the risk of patients suffering heart attacks and strokes.

The drugs have either been withdrawn from the market, or are accompanied by strong warnings of the possible damaging effects on health.

Q: Who took the decision to pull Vioxx from the market?

Merck voluntarily pulled Vioxx from the market in September 2004, five years after it had been approved for sale.

The firm was reacting to research carried out by its own teams, which discovered that taking the drug for 18 months or longer could double the risk of patients suffering a heart attack or stroke.

A US government study reached a similar conclusion of the drug’s dangers the same month.

The research, by the US Food and Drug Administration, concluded that 27,785 heart attacks or deaths might have been caused by Vioxx in the previous five years.

Q: What were the claims filed in the lawsuit?

A Texas woman, Carol Ernst, claimed Vioxx was to blame for her husband Robert’s death.

Mr Ernst, 59, had been taking the drug for eight months when he died of heart arrhythmia in his sleep in 2001. He was a marathon runner and triathlete who was using the drug to treat pain in his hands.

Merck insisted its drug was not to blame for Mr Ernst’s death. It said he had suffered from an irregular heartbeat and clogged arteries and it was these factors which led to his death.

But the jury agreed with his widow, and awarded her huge damages, including a large sum - £229m - specifically in punitive damages.

Q: What is in store for Merck?

The Texas trial was the first in what could ultimately be thousands of cases brought against Merck, both inside the US and around the world.

Key to this will be two more trials due to begin in the US later this year, in September in New Jersey and November in New Orleans.

If Merck loses those cases, it could open the floodgates, or force the drug company to settle cases out of court.

If it wins, many of the lawsuits may never be brought.

Merck says it will appeal against the first ruling and will fight any future lawsuits.

Analysts speculate that Merck’s liability if it loses could reach $18bn.

The markets have already reacted nervously to the Texas jury’s decision.

The company’s shares lost 7.7% of their value after the jury’s decision was announced, closing at $28.06. That wiped $5.2bn from the company’s value.

Q: Do drugs like Vioxx have a future?

Vioxx was one of Merck’s most important drugs, generating $2.5bn in sales in 2003, which accounted for about 10% of the company’s total revenue.

Some of the biggest pharmaceutical firms, including Merck but also GlaxoSmithKline, Novartis, Pfizer, have refused to abandon their believe in Cox-2 inhibitors.

They are conducting extensive research into the safety of other drugs in the same class, trying to prove they have a future of safe and effective pain control.

Merck still sells another drug in the Cox-2 class, Arcoxia. Although not approved in the US, it is approved in other 54 countries.

Celebrex, manufactured by Pfizer, is the only Cox-2 still available in the US market. Sales are said to be improving after the loss in confidence provoked by the withdrawal of Vioxx.

Source: BBC News August 20, 2005

 

Know about Diabetes

Filed under: Endocrine Disorders

What is Diabetes?

Diabetes is a disease in which the body produces too little of ineffective insulin. Insulin is a hormone that comes from a gland below the stomach, called the pancreas.

When the food you eat is digested, most of it break down into a sugar called glucose, which is absorbed into the blood.

In a normal person, insulin helps the blood glucose enter the body cells to be used for energy.

In a diabetic person with ineffective, too little or no insulin, the glucose cannot enter the body cells. It builds up in the blood, giving rise to a high blood glucose level which is the main sign of untreated or uncontrolled diabetes.

Types of Diabetes

The two main types of diabetes are Type 1 diabetes and Type 2 diabetes.

Type 1 Diabetes

This type of diabetes is usually found in children and young adults. The insulin-producing cells in the pancreas are destroyed, and the body produces practically no insulin.

You have a higher risk of developing Type 1 diabetes if your parent or sibling is a diabetic.

Type 1 diabetes can only be controlled with daily insulin injections, as well as proper diet and exercise.

The warning symptoms of Type 1 diabetes include:

  • nausea and vomiting
  • extreme thirst with frequent urination
  • extreme hunger with rapid weight loss
  • tiredness and irritability

These symptoms usually occur suddenly. Prompt treatment is necessary. See you doctor immediately if you have these symptoms.

Type 2 Diabetes

This is the most common type of diabetes in Singapore. Insulin is produced by the body, but it may not be enough or it may not work effectively.

More and more Singaporeans are getting Type 2 diabetes because of changes in lifestyle which increase the risk of getting diabetes. The risk factors of Type 2 diabetes are:

  • Lack of exercise and being overweight
      Type 2 diabetes is more common in people who do not exercise regularly and who are overweight.
  • Family history
      The risk of a person getting Type 2 diabetes is increased if one’s parent, grandparent or sibling is diabetes, and even higher if both parents are diabetes.
  • Age
      In Singapore, Type 2 diabetes commonly affects those over 40 years of age.
  • Ethnic group
      Type 2 diabetes is more common in Indians than in Malays or Chinese. But the number of people with Type 2 diabetes is increasing in all three ethnic groups.
  • High blood pressure, high blood cholesterol and smoking
      Studies have shown that people with high blood pressure, high blood cholesterol levels and smokers have an increased risk of getting Type 2 diabetes.

Diabetes can sometimes develop during pregnancy, or it can become worse in diabetic woman during pregnancy. A woman who has diabetes during pregnancy is also at higher risk of developing Type 2 diabetes later in life.

Type 2 diabetes can often be controlled with proper diet and exercise alone. For some, tablets are needed to stimulate the production of more insulin, or to improve the action of ineffective insulin. In severe cases, insulin injections are needed.

Persons with Type 2 diabetes often have no warning symptoms. Some only discover they have the disease after a routine blood test, or when they develop complications.

If warning symptoms occur, they may include:

  • fungal infection and itching of the genital area
  • thirst with frequent urination
  • unexplained weight loss
  • blurred vision or a change in vision
  • numbness or tingling of hands or feet
  • slow healing of wounds
  • tiredness and irritability

These symptoms usually occur gradually. See your doctor as soon as possible. Early treatment improves the chances of preventing or delaying complications.

Complications of Diabetes

Untreated or uncontrolled diabetes leads to serious complications.

A persistent high blood glucose level damages the small and large blood vessels in the body, particularly in the eyes, kidneys, nerves, heart and brain. Blood flow to the various organs and tissues is reduced or even cut off, causing damage.

If the nerves in the hands and feet are affected, there is a loss of feeling. Such diabetics often injure themselves without realising it. The wounds are slow to heal and become infected easily.

Complication of diabetes are:

  • coma or loss of consciousness
  • blindness
  • high blood pressure
  • kidney disease
  • heart disease
  • stroke
  • gangrene or decay of the limbs, which may require…
  • amputation

Is there A Cure?

There is no cure for diabetes at present. But the disease can be controlled with lifelong treatment.

Good control of blood glucose level will help prevent or delay the complications of diabetes, and enable a diabetic person to live a normal life.

Prevention

At present, it is not possible to prevent Type 1 diabetes. However, Type 2 diabetes, which is often associated with being overweight, may be prevented by:

  • Maintaining a healthy weight
      Excess fat prevents insulin from working properly.
  • Eating a balanced diet
      Take the correct number of servings from each of the basic food groups for your age and level of activity. Avoid too much sugar, salt, fat and high-cholesterol foods.
  • Exercising regularly
      This uses up blood glucose and body fat, improves blood circulation and strengthens the heart. It helps to control weight and improves insulin action.
  • Not smoking
      If you’re a smoker, stop now. Ask your family doctor for advice on quitting. If you are a non-smoker, don’t start.
 
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