If these naproxen data were to hold up, they would be particularly surprising and worrisome.
Some analysts have argued, however, that risk for naproxen would bode well for Pfizer on Celebrex.
Naproxen was thought to be slightly protective for the heart, like a weak aspirin.
If a drug could match naproxen, he said, he'd be reasonably comfortable with its heart safety.
Over-the-counter nonsteroidal anti-inflammatory drugs such as aspirin, naproxen and ibuprofen offer relief to some patients.
Naproxen, Merck argued, helped the heart in much the same way aspirin does--and the comparison looked bad.
The results came from a trial called Adapt, testing naproxen and Celebrex as preventatives for Alzheimer's disease.
Widely-used pain medications like ibuprofen and naproxen can, in rare cases, cause ulcers in the stomach or intestines.
Celebrex treats pain as well as other NSAIDS, or non-steroidal anti-inflammatory drugs, such as ibuprofen, naproxen and aspirin.
But if naproxen poses a heart risk, so might many over-the-counter anti-inflammatory drugs.
It is also possible that older painkillers like ibuprofen and naproxen were studied less rigorously that Vioxx and Celebrex.
There are 20 other arthritis pills already available, including ibuprofen, naproxen and diclofenac.
Merck used a supposed naproxen benefit to try to explain away results in which Vioxx had caused more heart attacks.
Naproxen is an older drug sold by Bayer (nyse: BAY - news - people ) as Aleve.
Part of the reason for this distinction was that the Celebrex cardiovascular data mirrored that of NSAIDs like naproxen and ibuprofen.
FORBES: Vioxx and Diclofenac: Why Are Two Heart Risky Pain Drugs Viewed Differently?
The FDA panel had indicated that naproxen, sold by Bayer as Aleve, probably had the lowest heart risk of the bunch.
There were fewer cardiac problems when patients were given an older painkiller, naproxen, but naproxen is known to have a cardiac benefit.
Eric Topol , the top cardiologist at the Cleveland Clinic, notes that previous studies suggest naproxen might have had a heart benefit.
Nissen was worried by something he saw in the data: Vioxx caused significantly more cardiovascular events than naproxen, an older pain drug.
On Monday, the FDA turned a halted clinical trial into a very scary warning about Aleve (see: " FDA Statement On Naproxen").
Another panel member, Steven Nissen of the Cleveland Clinic, likened releasing a warning on naproxen to yelling "fire" in a crowded auditorium.
In the meantime, doctors are going to spend a great deal of time worrying about exactly how much naproxen helps the heart.
Merck has argued that Vioxx is safe and that the difference in its trial was due to a cardiovascular benefit from naproxen.
Searle, a predecessor to Pfizer, back in 1988 as a drug to prevent drugs like aspirin and naproxen from causing ulcers.
The statement warned of a 50% increase in cardiovascular events with naproxen.
Farkouh contends that the benefit of naproxen simply makes Prexige look worse.
Indomethacin or naproxen or other strong nonsteroidal anti-inflammatory drugs are also useful.
But the company insisted the risk was an illusion caused by comparing Vioxx with naproxen, another pain pill they said protected the heart.
For arthritis drugs, data is most likely to come from a Pfizer-sponsored study comparing the heart safety of Celebrex with ibuprofen and naproxen.
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