www.midwesterndoctor.com/p/healing-back-pain-and-ending-the
2 corrections found
at typical doses they cause a 5 to 15% loss of bone every year
This overstates steroid-related bone loss. Reviews and guidelines describe about 5–15% bone loss in the first year of glucocorticoid therapy, followed by a slower decline thereafter—not 5–15% every year.
Full reasoning
The article changes "during the first year" into "every year", which is a materially different claim.
Recent reviews of glucocorticoid-induced osteoporosis describe a rapid initial phase of bone loss after starting systemic glucocorticoids, followed by a slower continuing decline. For example, the Belgian Bone Club consensus review states that in patients starting glucocorticoids there is a 6–12% decline in lumbar-spine bone mineral density in the first year, followed by a slower but continuous decline thereafter. Another review cited in the literature likewise says bone loss can be 5–15% during the first year of treatment.
So the article's wording is inaccurate because it implies patients lose 5–15% of bone mass each year indefinitely, whereas the evidence it points to describes that magnitude primarily in the first year, with lower rates later on.
2 sources
- Prevention and Treatment of Glucocorticoid-Induced Osteoporosis in Adults: Consensus Recommendations From the Belgian Bone Club
In patients starting glucocorticoids, there is a rapid phase of bone loss (6-12% decline in lumbar spine bone mineral density in the first year), followed by a slower but continuous decline thereafter.
- Glucocorticoid-induced osteoporosis
According to a meta-analysis of 56 cross-sectional studies and 10 longitudinal studies, bone loss assessed by dual-energy X-ray absorptiometry, can be 5–15% during the first year of treatment.
Vioxx and Celebrex jointly are estimated to have killed roughly 195,000 people
This death toll is vastly inflated. The best-known Vioxx estimate was about 88,000–139,000 excess cases with 30–40% fatality (~35,000–56,000 deaths), while published celecoxib evidence does not support adding another ~140,000 deaths.
Full reasoning
The article appears to conflate excess cardiovascular events with deaths, and then attributes an unsupported combined fatality figure to Vioxx and Celebrex.
For Vioxx (rofecoxib), FDA safety scientist David Graham's Senate testimony gave an estimate of 88,000 to 139,000 excess cases attributable to Vioxx, adding that 30–40% probably died. That implies roughly 35,000 to 56,000 deaths, not 195,000.
For Celebrex (celecoxib), the evidence does show cardiovascular risk warnings, especially at some doses, but the published meta-analysis cited below found no significant increase in cardiovascular death (odds ratio 1.02, 95% CI 0.52–1.99). FDA/DailyMed labeling warns of potentially fatal cardiovascular events, but it does not estimate anything close to another ~140,000 deaths attributable to celecoxib.
So the statement "jointly ... killed roughly 195,000 people" is not supported by the established estimates and substantially overstates the documented death toll.
3 sources
- Testimony of David J. Graham, MD, MPH (Nov. 18, 2004)
This estimate ranges from 88,000 to 139,000 Americans. Of these, 30-40% probably died.
- Risk of cardiovascular events and celecoxib: a systematic review and meta-analysis
The odds ratio for the risk of a cardiovascular death with celecoxib therapy was 1.02 (95% CI 0.52 to 1.99).
- CELEBREX (celecoxib) capsules — Highlights of Prescribing Information
CELEBREX may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal.