After rofecoxib, CV risks warrant close monitoring.(Rheumatology)(Disease/Disorder overview)

Publication: Internal Medicine News

Publication Date: 15-JUN-06

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COPYRIGHT 2006 International Medical News Group

To minimize the danger of a heart attack or stroke, patients who have previously taken rofecoxib should receive daily low-dose aspirin and ongoing cardiovascular monitoring, experts say.

These patients appear to be at increased risk of heart attack or stroke for at least the first year after they discontinued therapy, according to expert interpretation of new data released by Merck & Co.

"The risk appears to be small, but it does appear to be clinically relevant," Dr. Roy Altman, a rheumatologist at the University of California, Los Angeles, said in an interview. "I think keeping a closer eye on [these patients], especially on those who have cardiovascular risk factors, and giving the daily aspirin is not an unreasonable thing to do."

Dr. Steven Nissen, president of the American College of Cardiology, agreed. "People who formerly took [rofecoxib] should be monitored closely, and I will recommend to any patient I see that they take the low-dose aspirin for prophylaxis. If there is additional ongoing risk, why not try to ameliorate it?"

In a recent conference call, Merck officials said their finding of a 64% increased risk of heart attack and ischemic stroke in patients' first year off rofecoxib (Vioxx) was not statistically significant and did not conclusively link the drug with adverse events during that time. But both Dr. Altman and Dr. Nissen said in interviews that the association...

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