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Alternatives to Vioxx


ABC Submits Letter to the Editor of the WSJ Regarding Natural Alternatives to Vioxx

In the wake of the recent recall of the popular drug Vioxx due to recent research demonstrating that it can increase the risk of heart disease, there has been a rush by media to cover this story. The Wall St. Journal (WSJ) is one of the many media outlets producing articles on this topic.

On Saturday, October 2, ABC Founder and Executive Director, Mark Blumenthal, was interviewed by WSJ reporter Paul Davies for a story on various natural alternatives in the dietary supplement industry that consumers might use an acceptable substitute for Vioxx® (the multibillion dollar pain reliever from Merck). Unfortunately, none of Blumenthal’s comments were used in the article published Tuesday, October 5, 2004. As a result, Blumenthal wrote a letter to the editor of the WSJ that has not been published. Additionally, ABC has received no response from the author for repeated requests for a copy of the article.

Vioxx is a known for its primary mechanism of action of inhibiting the enzyme cycloogygenase-2 (COX-2), an enzyme involved in the production of prostaglandins and the resulting inflammatory process. Inhibition of COX-2 is a successful strategy developed recently for pharmaceutical drugs for controlling inflammation and associated pain.

In his interview with the author of the WSJ article, Blumenthal discussed herbs containing compounds with demonstrated COX-2 inhibiting activity, particularly ginger and turmeric. He stated that both these herbs contain compounds that have shown COX-2 inhibiting activity in published research. He also noted that several proprietary herbal dietary supplement formulations intended to help manage inflammatory conditions have included ginger (and/or turmeric) as primary ingredients. He also stressed the safety of these time-honored herbs as foods and spices, noting that turmeric is the spice that gives prepared mustard its bright yellow color.

One of the specific products he mentioned is Zyflammend® (New Chapter Inc., Brattleboro, VT), a proprietary combination of carbon dioxide extracts of ginger, turmeric, rosemary, green tea and other herbs with Cox-2 inhibiting and antioxidant activities. He also mentioned a Danish formulation made from ginger root and galangal root (Alpinia galangal, an herb in the ginger family), which has been shown effective in treating pain and symptoms of osteoarthritis of the knee in at least one clinical trial. The Danish formulation is imported into the U.S. by several companies, including Enzymatic Therapy (Green Bay, WI) under the trade name FlexAgilityTM in health food stores, and EV.EXT 77 (the original Danish product name) also sold under that name in the U.S. under the PhytoPharmica line in independent pharmacies and by various health care practitioners.

Blumenthal also mentioned the well-known benefits and safety of glucosamine sulfate for providing relief from osteoarthritic conditions. In a follow up email this morning, Blumenthal also noted the potential benefits and COX-2 inhibiting effects of boswellia (Boswellia serrata) and compounds derived from it (e.g., boswellin), found in many Ayurvedic herbal formulations. Blumenthal also mentioned that many “generic” ginger and turmeric herbal products would probably offer some valued assistance to consumers suffering from pain and swelling associated with various types of arthritis, but that most of these products have not been subject to controlled clinical trials to test and document their benefits in this area.

October 5, 2004
Letters to the Editor
The Wall Street Journal
200 Liberty Street
New York, NY 10281
Sent via email:

Re: “Evaluating Vioxx Alternatives” by Paul Davies and Heather Von Tesoriero, October 5, 2004.

To the Editor:

Your article explored various alternative treatments for controlling arthritis pain and inflammation after the Vioxx recall, but it failed to include a promising area of unconventional therapy: herbal dietary supplements.

The primary mechanism of action of Vioxx is inhibition of cycloogygenase-2 (COX-2), an enzyme involved in the production of prostaglandins and the resulting inflammatory process. The common spices ginger and turmeric, and numerous other herbs, contain compounds that have demonstrated COX-2 inhibiting activity in laboratory and animal studies.

As I told your reporter, Mr. Davies, when he interviewed me for this story, a 2001 study on a Danish ginger formulation (known as EV.EXT 77, or FlexAgilityTM in the U.S.) reduced pain and improved symptoms of osteoarthritis of the knee.

While more clinical research is clearly needed, a growing body of science suggests that selected herbal supplements may provide former Vioxx patients with safe, low-cost relief from pain and inflammation. This information should have been included in your article for the benefit of your readers.

Mark Blumenthal
Founder and Executive Director
American Botanical Council
Austin, Texas
Editor, HerbalGram

P.S. References available upon request

Note: Product brands are included as part of the American Botanical Council’s policy to provide names of clinically researched brands. This is done as an acknowledgement of the specific formulation upon which scientific and medical research is conducted. An independent research and education nonprofit organization, ABC does not recommend or promote specific products.

EV.EXT 77 is a proprietary combination of ginger and galangal roots, manufactured by Ferrosan A/S in Soeborg, Denmark. This product is imported into the U.S. and sold as FlexAgility by Enzymatic Therapy of Green Bay, WI and as EV.EXT 77 by PhytoPharmica of Green Bay. EV.EXT 77 was subject of a human clinical study: Altman RD, Marcussen KC. Effects of a ginger extract on knee pain in patients with osteoarthritis. Arthritis Rheum 2001 Nov44(11):2531-8.

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