THURSDAY, Dec. 30, 2004 (HealthDayNews) -- For years, Americans turned to the blockbuster drugs Vioxx and Celebrex for relief from chronic pain. But as 2004 ends, Vioxx is no longer on the market and the future of Celebrex remains unclear.
The tattered reputation of the cox-2 inhibitor class of analgesics not only left millions without their preferred method of pain relief, it also prompted criticism of the role -- even the integrity -- of the U.S. Food and Drug Administration, making the drug debacle the year's top health news story.
Other stories vied for that top spot, however -- this fall's flu vaccine shortage, an impassioned election-year debate over stem cell research, and new warnings from the FDA on heightened suicide risks in children taking antidepressants.
Here are the Top 10 health stories for 2004, as determined by HealthDay editors:
- Vioxx, Celebrex Lose Their Luster. The billion-dollar blockbuster drug Vioxx fell first, with maker Merck & Co. withdrawing it from the market in September after data linked long-term use of the medication with increased cardiovascular risk. Earlier this month, similar findings surfaced regarding Pfizer's Celebrex, although that drug remains on pharmacy shelves. Cardiovascular concerns have also put the spotlight on a popular over-the-counter cox-1 inhibitor, Aleve. The FDA ordered a review of trial data on Celebrex and a third cox-2, Bextra, while battling its critics. Those include agency "whistleblower" Dr. David Graham, who claimed the FDA pressured him to downplay results of a study reviewing the safety of Vioxx.
- More Americans "Import" Drugs From Canada. The Bush administration this week said the importation of cheaper prescription drugs from Canada would offer U.S. consumers little, if any, cost savings. Consumers may not be listening, however -- experts estimate that Americans this year spent more than $1.4 billion on drugs from foreign pharmacies. And in August, Illinois Governor Rod Blagojevich led what amounted to a states-rights rebellion, announcing plans to grant citizens online access to pharmacies in the United Kingdom and Canada, even as President Bush expressed doubts about the safety of foreign drugs.
- U.S. Flu Vaccine Supply Falls Short. In early October, federal health officials announced that the nation's supply of flu vaccine had been slashed by nearly half after a key manufacturer detected bacterial contamination in this year's batch. State and federal officials scrambled to make up the difference, securing additional -- but not nearly enough -- vaccines from other sources. In the meantime, distribution of available vaccine remains restricted to those aged 50 and older, small children, pregnant women, and those with chronic health conditions.
- Antidepressants' Link to Child Suicide Prompts Warning. After a series of emotional public hearings in Washington, D.C., the FDA in October followed the advice of two advisory committees and slapped a tough "black box" warning on antidepressants such as Prozac and Zoloft, warning doctors to watch for signs of suicidal behavior in pediatric patients. FDA commissioner Dr. Lester Crawford stressed, however, that the drugs also provide "significant benefit" to many depressed children.
- Pioneer Researcher Casts Doubt on PSA Test. It's been a health-care staple for older men for years -- the annual PSA blood test, used to detect prostate cancer. But in May, Dr. Thomas Stamey, the researcher who first identified the screen, said 20 years of data suggest the test "is no longer finding significant cancers." Other experts believe the test is still useful in detecting early malignancies, and the American Cancer Society continues to recommend PSA screening for men over 50.
- Good News, Bad News For Breast Cancer. Women battling breast cancer had some reason to cheer in '04: Researchers found the drug Arimidex (anastrazole) to be significantly more effective than the "gold standard" medication, tamoxifen, at keeping breast cancer survivors cancer-free over the long term. On the down side, new research found that hormone replacement therapy -- already blamed for raising risks for breast cancer -- might also make tumors harder to detect on mammogram.
- Reagans, Reeve Re-Energize Stem Cell Debate. Microscopic embryonic stem cells became powerful players in the 2004 election cycle, with Nancy Reagan and Ron Reagan Jr. breaking ranks with the Republican Party to issue impassioned pleas for their use in research into Alzheimer's and other illnesses. Weeks before his death in October, actor Christopher Reeve appeared alongside Democratic presidential nominee John Kerry, asking for similar action. In California, at least, Reeve and the Reagans got their wish: Voters there said "yes" to a ballot earmarking $3 billion in state funds for embryonic stem cell research.
- Low-Carb Craze Crumbles. It has been a long, pasta-free run, but America's fixation with low-carbohydrate regimens may finally be past its peak. In February, nearly one in 10 (9.1 percent) of all Americans said they shunned carbs on a regular basis. But in a poll taken just before Christmas, that percentage had dropped by nearly half, to just 4.9 percent. And a study released this month found that of the nation's 10 most popular diet regimens, only Weight Watchers keeps the pounds off over the long term.
- Cholesterol Busters Get A Boost. In July, the nation's leading consortium of experts on cholesterol control issued new guidelines recommending that patients use even higher doses of statin medications such as Lipitor or Pravachol, to help lower levels of vessel-clogging fats. The recommendations also encourage healthy diet and exercise -- especially timely, with U.S. health officials this year labeling obesity as one of the country's major killers.
- Tougher Transplant Rules After Rabies Deaths. This summer, doctors at Baylor University Medical, Dallas, announced that four transplant patients had died from rabies after receiving organs and tissues from a donor infected with the disease. The Texas deaths prompted officials at the FDA to tighten rules governing "good tissue practice." The new guidelines should help reduce contamination and improve the labeling and distribution of transplant materials.
