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Nature 448, 400-401 (26 July 2007) | doi:10.1038/448400a; Published online 25 July 2007

The pain game

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The safety problems that brought down Vioxx have tainted a whole class of drugs. Meredith Wadman examines their chances of a comeback.

Few were surprised this spring when an advisory panel to the US Food and Drug Administration (FDA) trounced Merck's Arcoxia (etoricoxib) in a 20–1 vote. The painkiller was, after all, a 'COX2 inhibitor' — a relative of Vioxx (rofecoxib), the Merck pill that was pulled from global markets in 2004 for increasing the risk of heart attacks and strokes.