"Clearly it's a disease. A disease that becomes more frequent as we age," Brandt said. "But it's treatable and maybe even preventable. Among women, those who are in the top 20 percent for obesity have more than a seven-fold risk increase compared to women of normal weight. If they lose weight before they get osteoarthritis, the risk goes down. Once you get symptoms, weight loss still benefits them."

The rheumatology college suggests using over-the-counter pain relievers to manage mild-to-moderate joint pain, "starting with a simple analgesic such as acetaminophen," according to its treatment guidelines. It noted that in many patients with the disease, acetaminophen relieves pain as effectively as the NSAIDs and has a better safety profile, even compared to other over-the-counter pain medications — as long as it's used as directed. Some of the others, including aspirin, naproxen sodium, ketoprofen and even ibuprofen can sometimes cause gastric irritation, it said.

NSAIDs, in the lowest dose possible for a short time, are recommended if that doesn't work.

Instead of panicking about the withdrawal of yet another medication, Brandt said, people need to know that "the level of satisfaction with all of them is not very great.

"Clearly there are some patients with osteoarthritis who do better with Cox-2 than an alternative, but the proportion is small. The bulk of such patients can be managed as they were before the drugs were available, with the use of nonmedicinal measures and overlay it with over-the-counter medication in low dose."

The Cox-2 drugs quickly became popular because they provided the pain relief of older medications without the gastric side effects, which could become serious. And though problems have emerged, he said, their development has led to greater understanding of the body's different mechanisms of the body, such as how to bock block one effect but not another using designer drugs. The drug was as effective but not more effective at controlling pain than other medications.

"I think we're too pessimistic, too nihilistic, about osteoarthritis," Brandt said. "There's a sense of inevitability to this — we're bound to get it as we're getting older. Those are not warranted assumptions."

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E-mail: lois@desnews.com