This is an excerpt from an article called "Medical reversals – when doctors hurt patients". The original article looks at four examples of medical practices that have done more harm than good, but here it is shortened with the author's permission to examine just the example of non-steroidal anti-inflammatory drugs, or NSAID's.
I’ve been asked why I’m so skeptical when it comes to health and medical science. My answer is because I’ve spent many hours studying medical history, and I’ve seen how much damage doctors have done over the centuries. If you were to select a patient-doctor consultation at random from all the ones that have happened throughout history, your odds are probably better of selecting one in which the doctor harmed the patient than one in which the doctor helped the patient. That is certainly true if you only look at consultations happening before the year 1900.
It’s a shame that medical history generally isn’t part of the curriculum in medical school. If it was, maybe doctors would be more humble about what they know, and what they don’t know. If I were to design a medical school curriculum, I would make the first five to ten weeks of medical school an in-depth course in medical history, with a particular focus on all the mistakes doctors and scientists have made through the centuries, and why they made those mistakes. To quote a well worn cliché, those who don’t know history are doomed to repeat it.
Personally, I wear my skepticism as a badge of pride. If I were to seek out a doctor for some medical condition I was suffering from, I would want that person to be a natural skeptic. I would want someone who won’t believe something just because that’s what they were taught in medical school, or because it’s what they heard from a salesperson working for a pharmaceutical company.
Things can often seem to be very beneficial after a few early studies, or because common sense suggests they should be beneficial. Then when more data comes in, sometimes decades after a certain treatment has become the “gold standard” of therapy, it becomes clear that the intervention is actively harmful. In some cases, millions of people have died prematurely as a result of the intervention by this point. When this happens, when something goes from being the recommended therapy to turning around 180 degrees and becoming something that doctors recommend against, it is known as a medical reversal. Unfortunately, medical reversals are common.
Non-steroidal anti-inflammatory drugs (NSAID’s) have been around for a long time. Aspirin was invented in the 1890’s, and ibuprofen has been around since the early 1960’s. One problem with these drugs, which has been recognized since the early days, is that they can cause stomach ulcers. In fact, over-use of NSAID’s is one of the most common reasons for emergency hospital admissions due to bleeding ulcers.
The reason for this side-effect is that NSAID’s block an enzyme called cyclo-oxygenase, generally shortened to just COX (another name for NSAID’s is COX-inhibitors). There are two different versions of COX, COX-1 and COX-2. All the early NSAID’s are unselective COX-inhibitors. In other words, they block both COX-1 and COX-2.
At some point it was discovered that the entire positive effect that comes from NSAID’s, in terms of decreasing inflammation and pain, comes from their inhibition of COX-2, while inhibition of COX-1 is responsible for the side effect of increased bleeding. This naturally led drug companies to seek to develop specific COX-2 inhibitors, that would decrease inflammation, but not cause stomach ulcers.
In 1999, the first two COX-2 selective inhibitors came on the market, rofecoxib (a.k.a. Vioxx), produced by Merck, and celecoxib (a.k.a. Celebrex), produced by Pfizer. They instantly become some of the best selling drugs in the world. Of the two, rofecoxib was much better at blocking COX-2 specifically, and thus far less likely to cause stomach ulcers.
After a few years on the market, signals started to appear that rofecoxib was associated with a heavily increased risk of heart attack and stroke. In fact, people taking rofecoxib had something like a 300% increased risk of having a heart attack compared with people taking non-selective NSAID’s. Merck’s initial response was, unsurprisingly, to try to put the lid on this information. But by 2004, the cat was well and truly out of the bag. In the face of mounting criticism (and lawsuits), Merck chose to withdraw the drug from the market. By that point, 80 million people had been treated with rofecoxib and around 100,000 people had suffered unnecessary heart attacks.
DAV (Deer Antler Velvet) is used by many people throughout the world as an alternative to NSAID drugs for supporting joint health.
Chinese literature reports the successful use of deer velvet products as a medicinal product for more than 2000 years, and research evidence supports claims that velvet antler use can enhance joint structure and function in people and animals.
