1 August 2006

A review of lumiracoxib (Prexige), which helps prescribers to assess the balance of risks and benefits for individual patients, is in the latest edition of NPS RADAR.

The review outlines the potential gastrointestinal benefits and cardiovascular harms, and discusses where this new medicine might fit amongst the analgesic options for osteoarthritis.

Lumiracoxib is the first COX-2 selective NSAID to become available in Australia in the post-Vioxx era. It can be prescribed on the PBS for osteoarthritis from 1 August 2006.

While the cardiovascular risk associated with NSAIDs remains under intense scrutiny, lumiracoxib was recommended for listing on the PBS on the basis that it is at least as costeffective as celecoxib.

‘NPS RADAR concludes that paracetamol remains the first-line treatment for managing pain in osteoarthritis, and lumiracoxib is an alternative to other NSAIDs,’ Dr Peter Roush of the National Prescribing Service, said.

‘With all drugs, the potential benefits of use must be balanced against the risks of use. For people who are at increased risk of upper gastrointestinal ulcers, this NSAID may have significant benefits over conventional NSAIDs, but there still are unknowns about risk to the heart and all NSAIDs carry the risk of renal adverse effects and drug interactions.

‘Although the large TARGET study shows lumiracoxib causes fewer serious ulcer complications than naproxen or ibuprofen, lumiracoxib still should be used with caution in people with gastrointestinal risk factors.

‘Evidence for the long-term cardiovascular safety of lumiracoxib is limited. It is contraindicated in patients with established cardiovascular disease and should be prescribed with caution for patients with significant cardiovascular risk factors.

‘NPS RADAR recommends using any NSAID for the shortest possible time and suggests intermittent use for symptomatic relief, or before painful activities,’ Dr Roush said.

ENDS

NPS RADAR provides independent information about new medicines and changes to PBS listings important to GPs, pharmacists and other health professionals involved in primary care management of patients.