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It appears that most attorneys don't have a clue as to the many different conditions caused by Vioxx.  They seem to think that Vioxx is limited to thrombus events and myocardial infacrtions.  I have considered the following information which was found on the net in various places:

COX-1 promotes thrombotic obstruction in arteries, while COX-2 increases vasodilatory and anti-aggregatory prostacyclin production, thus restraining the process of thrombotic activity.  In tandem, COX-1 and COX-2 keep the clotting process in check. By selectively inhibiting COX-2, however, but not COX-1, VIOXX increases the relative risk of a confirmed adjudicated thrombotic cardiovascular event, i.e., myocardial infarction, unstable angina, cardiac thrombus, resuscitated cardiac arrest, sudden or unexplained death, ischemic stroke, and transient ischemic attacks.  In short, by inhibiting the body’s production of the COX-2 iso-enzyme, without a concurrent inhibition of the COX-1 enzyme, VIOXX interferes with the body’s ability to control it’s blood clotting mechanism.  The body is then induced into a state that produces blood clots.

VIOXX causes an acceleration of the process of atherosclerosis, otherwise known as “hardening-of-the-arteries.”  This causes the arteries to become more fragile and obstructed, leading to heart attacks, strokes, organ failure or damage, etc.   Studies have found that a fatty acid made by the COX-2 enzyme,  has a protective and preventative effect from the atherosclerosis process.  And thus, by shutting down COX-2 long term, VIOXX actually kick-starts and accelerates the process of atherosclerosis.  Evidence also suggests COX-2 inhibitors might be especially dangerous to younger women, who are normally protected biologically from heart disease.  Statistics show that younger women have less heart disease than those women who are past menopause.  It is believed that this is because the hormone estrogen, which is produced normally in younger women, triggers COX-2 activity, which leads to protection from atherosclerosis.

VIOXX causes an acceleration of the process of Fibromuscular Dysplasia (FMD).  FMD is a disease of arteries that most often affects the primary aortic branches. It causes normal smooth muscle cells to mutate and creates abnormalities and thickening in the fibromuscular lining of the arteries that often results in the formation of ‘web-like’ structures or ‘cold-sore-like’ lesions that restrict blood flow through the arteries and restricts the flow of lymphatic fluids through lymph vessels.  FMD can affect other vascular areas as well and sometimes causes stenosis, such as in: carotid artery stenosis, which often leads to strokes; renal artery stenosis, often leading to kidney failure or disorders, increased blood pressure, etc.; aortic stenosis, seen  in older adults, and leading to heart attacks.  FMD damages the immune, nervous and hormonal systems, and the metabolism. FMD also leads to the destruction of arterial blood vessels which can cause bleeding in the brain, damage to brain tissue, and also leads to strokes, and damage to other tissues and organs.

COX-2 inhibitors thus lead to arterial stenosis.  The word stenosis refers to the narrowing of an opening or vessel.  VIOXX can cause stenosis of arteries, and restricted or obstructed blood flow, in at least two different ways, i.e., through obstructive FMD lesions, and/or, through the acceleration of atherosclerotic plaque formation.  The stenosis and resulting alteration of blood flow then leads to various health risks and problems, such as heart attacks, strokes, organ failure or damage, etc.

VIOXX  neutralizes the protective effects of the COX-2 enzyme, which is a cardioprotective protein.  This makes one more susceptible to various heart abnormalities and ailments.

Inhibition of prostaglandin I2 formation by VIOXX can result in elevated blood pressure, accelerate atherogenesis, and increase the thrombotic response to rupture of an atherosclerotic plaque.

VIOXX can cause deposits of artery blocking plaque to become dangerously unstable, when combined with certain other drugs, such as an aspirin substitute.  Such changes result in a loss of stability of atherosclerotic plaque, making it more likely to rupture and activate clotting, causing heart attack or stroke.

If all of these effects are true, then we need to educate attorneys and others on ALL of these effects of Vioxx, so that we have a fighting chance against the big drug company.