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Wednesday, 5 June, 2002, 18:03 GMT 19:03 UK
Painkillers 'prevent bone healing'
The painkillers were given to rats in the study
The painkillers were given to rats in the study
Some painkillers may delay, or event prevent, bones healing say scientists.

A US study found that when rats were given non-steroidal anti-inflammatory drugs (NSAIDs), their broken bones healed more slowly that normal, or never fully healed.

Ibuprofen is one of the main types of NSAIDs, although it appeared to have less severe side effects than other kinds.

Dr Patrick O'Connor, from the University of New Jersey, who led the research, said: "Ibuprofen and indomethacin delay bone healing by about one to two weeks in rats, which is the equivalent to slowing it down by 25 to 50% in humans," says O'Connor.


People with healing fractures should steer clear of these drugs

Professor Jeremy Saklatvala, Kennedy Institute of Rheumatology
The team also gave the animals rofecoxib (brand name Vioxx) and celecoxib (Celebrex).

None of the rats given rofecoxib were able to heal their bones.

In those given celecoxib, none managed to completely heal their bones but about half had some form of bone regrowth.

Repair process

Over the last 20 years, there have been some reports of patients who took NSAIDs experiencing problems with bone repair.

The traditional type of NSAIDs prevent two enzymes called cox-1 and cox-2 from working.

Cox-2 is important because it stimulates the production of hormone-like chemicals called prostaglandins, which are involved in inflammation.

Cox-1 does a range of things, not specifically related to dealing with inflammation.

It was hoped newer NSAIDs, such as rofecoxib, which only block cox-2, would have fewer side effects but the US researchers suggest cox-2 may be crucial in helping bone-forming.

Cartilage calluses form as the first stage in a body repairing a bone, which is then converted into bone.

It appears to be this second stage which is affected by the blocking of cox-2.

Aspirin appears to work successfully as a pain killer without causing bone healing problems.

'Avoid these drugs'

Merck, the maker of rofecoxib, rejected the US study's findings, and said a study on spinal fusion operations had found patients given the drug did not find any problems with bone healing.

Dr Thomas Einhorn, an orthopaedic surgeon at Boston University Medical Center and also a paid consultant for Merck, said: "It would seem that a prudent approach is to temporarily avoid the use of these drugs during bone healing."

Jeremy Saklatvala, professor of cell biology at the Kennedy Institute of Rheumatology in London told BBC News Online the newer drugs were often taken by people with rheumatoid arthritis, rather than being used by people with broken legs.

He added: "They're not being bought in the chemist by people as painkillers."

He added: "You can't automatically extrapolate from animal experiments into humans, but the data is very convincing.

"In the meantime, people with healing fractures should steer clear of these drugs."

The research is published in New Scientist, and in the Journal of Bone and Mineral Research.

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