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Doctor warns against Vioxx use

Disputed drug could cause a heart attack after one day

ATLANTIC CITY -- Intermittent use of Vioxx or even a day's use of the painkiller could be enough to cause a heart attack, a prominent heart and medication expert testified yesterday on behalf of a man who is suing the maker of the drug, claiming it caused his heart attack.

Vioxx breaks down so slowly in the body that it takes about 85 hours to clear out of the blood, testified Dr. Benedict Lucchesi, a professor at the University of Michigan who helped develop the first pacemaker.

''Based on the science, there's every reason to believe that a single dose, multiple doses, whatever, can lead to an adverse event," such as a heart attack or stroke, Lucchesi said.

That could be a key point in 60-year-old Idaho postal worker Frederick ''Mike" Humeston's case against Vioxx maker Merck & Co.

Vioxx, launched in May 1999, was pulled from the market in September 2004 by Merck after its own research showed the blockbuster arthritis drug doubled the risk of heart attack and stroke after 18 months' use.

Humeston had a heart attack in 2001 after taking Vioxx for only two months and skipping some doses.

The company contends that Humeston's condition and sedentary lifestyle led to his heart attack.

Lucchesi also told jurors that repeated evidence and warning signs linked heart risks to the painkiller Vioxx before and shortly after its launch. Lucchesi said after reviewing correspondence among Merck executives and scientists that he was surprised the company didn't put more emphasis on those risks.

''This is bad news, obviously," he said, adding he didn't know how scientists ''could not know the potential for harm."

Lucchesi also testified that after a 2000 study showed significant heart risks to Vioxx users, Merck told doctors and the public Vioxx was safe. Lucchesi said that instead there was ''an explosion" of reports by Merck executives and consultants saying that the other drug in that study, Naproxen, prevented heart attacks, not that Vioxx caused them.

Plaintiff attorneys and some doctors have argued Merck knew the risks of Vioxx at least a few years before it took the drug off the market, yet downplayed its dangers and kept aggressively promoting the drug. Attorneys for Merck say the company acted responsibly, putting patients first and pulling the drug once the risks surfaced.

Merck faces more than 5,000 lawsuits over Vioxx filed in state and federal courts -- about half of them in New Jersey state courts.

The first trial ended last month when a Texas jury stunned Merck with a $253 million liability verdict although that will be slashed to about $26 million because Texas caps punitive damages. Merck plans to appeal. Lucchesi also testified against Merck in that trial.

Lucchesi said yesterday he felt funny testifying against Merck after having a positive relationship with its scientists for years; the company even helped pay for training of some of his graduate students.

''Merck has been extremely good to me over the years," he said.

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