Misleading Ad for Apeaz

An ad for Apeaz in Discover Magazine is misleading. Its active ingredient may provide some temporary relief of pain, but the claims in the ad are overblown. It is not a new blockbuster drug or an anesthetic.

I saw a full-page ad in Discover Magazine for Apeaz, a “New blockbuster arthritis drug” in the form of a cream. Almost everything in the ad was wrong. The active ingredient is methyl salicylate, which is not new, is not a blockbuster, and cannot replace disease-modifying treatments. That was bad enough, but it went downhill from there.

The claims

  • New Arthritis Painkiller Works on Contact and Numbs Pain in Minutes.
  • Uses the strongest approved dose of an anesthetic drug.
  • Anesthetics are highly regarded by physicians in the medical community.
  • Numbs the nerves that cause relentless joint pain.
  • It numbs the nerves right below the skin but also apparently reaches the arthritic joint itself (!?)
  • Rapid relief that lasts for hours and hours
  • Offers impressive advantages over traditional medications:
    • Faster action
    • None of the negative side effects of oral medications
    • The chemicals in pills can tear the delicate lining of the stomach, causing ulcers and bleeding.
    • Lower cost: less than $2 a day
  • An FDA drug [sic] with approved claims for the pain relief of the following conditions:
    • Temporary pain
    • Strains
    • Athletic injuries
    • Simple back pain
    • Sprains
    • Muscle stiffness/pain
    • Wrist, elbow, shoulder, hip, knee, ankle, foot, muscle or joint pain

The active ingredient

Methyl salicylate, a relative of aspirin, is a nonsteroidal anti-inflammatory drug (NSAID) also known as oil of wintergreen. It is the active ingredient in many over-the-counter remedies like Bengay. It acts as a counterirritant, which (along with rubbing the painful area as it is applied) tends to distract patients from their pain. It is well absorbed and then is metabolized into salicylic acid which has some analgesic and anti-inflammatory properties, but there’s no rigorous research to support its use for pain.

Evidence?

The ad says, “Published pre-clinical animal studies have shown that the other ingredients in Apeaz can also prevent further bone and cartilage destruction.” What other ingredients? It contains menthol and camphor, but the study I found called them “inactive ingredients”.

It was a 2009 study in a mouse collagen induced arthritis model that “shares a number of clinical, histological and immunologic features with RA (rheumatoid arthritis).” The researchers explained that the active ingredient of Apeaz is methyl salicylate and that it also contains the “inactive ingredients” glucosamine sulfate, menthol, camphor and methyl sulfonyl ethane. They reported finding downregulation of both inflammatory and autoimmune components of the disease. They said:

Treatment with Apeaz™ completely abrogated joint swelling and destruction of cartilage and bone as demonstrated by histopathology and X-ray analysis of joints. In addition, Apeaz™ reduced the levels of inflammatory cytokines in the joints of arthritic mice. Our data suggest that Apeaz™ could be a viable candidate as a DMARD [Disease Modifying AntiRheumatic Drug] for RA.

That is preliminary, speculative, and the suggestion is not warranted. Mice are not humans, and the induced model in mice is not the same as RA in humans. Apeaz has not been studied in human clinical trials.

Silly mistakes

  • “Getting to the source of you [sic] pain”
  • They offer a special hotline for discounted pricing that will be available at 6:00 AM “today” and will only be open for the next 48 hours. Don’t they realize that Discover is a monthly magazine? One wonders how “today” is supposed to be interpreted. The day of publication? The day a subscriber receives a copy? Would it apply to readers who picked up an old copy in the dentist’s waiting room?
  • This is the initial public release, but they claim “thousands of consumers” have already experienced the “guaranteed” Apeaz relief. How could that be? And they don’t mention any guarantee.
  • Calling it an “anesthetic” is a real stretch, if not an outright lie. While Apeaz may produce a mild numbing sensation, it is not an anesthetic by any scientific definition of the word.

Fake news

The ad might be confused with a news story. It carries a byline: “By David Watson, Associated Health Press.” There is no such organization and no such person. These ads are typically published in daily newspapers, which explains the confusion about “today”. The newspaper ads have the same wording and the same warning not to wait because supplies may run out. But they do have a different toll-free number to call. And the newspaper ad also advertises a companion product, ArthriVarx, which supposedly works on the inside to cushion the joints while Apeaz is working on the surface pain. But wait! Didn’t they say Apeaz reaches the joints?

Believing the ads could harm patients

This product has not been tested in humans. Patients with rheumatoid and other inflammatory types of arthritis can be treated with DMARDs which are proven to reduce the chance of permanent joint damage, disability, and deformity; and DMARDs are more effective when started early in the course of the disease. Patients may not know what type of arthritis they have. It would be unfortunate if patients with RA relied on Apeaz and delayed getting effective treatment.

Shame on Discover!

Discover Magazine claims to be “Science for the Curious”, and the issue that this ad appeared in featured the top stories of 2019 in medicine. Publishing ads like this undermines their scientific message and lends a false prestige to non-scientific claims. Topical application of wintergreen oil may provide some temporary relief of pain, but questions remain:

  • How well does it work?
  • How does it compare to other treatments?
  • How many customers who would benefit from proven DMARDs will use Apeaz instead and become needlessly crippled with permanent joint damage?

There are no answers to these questions, because the necessary controlled scientific studies have not been done.

This article was originally published in the Science-Based Medicine Blog.

Dr. Hall is a contributing editor to both Skeptic magazine and the Skeptical Inquirer. She is a weekly contributor to the Science-Based Medicine blog and is one of its editors. She has also contributed to Quackwatch and to a number of other respected journals and publications. She is the author of Women Aren’t Supposed to Fly: The Memoirs of a Female Flight Surgeon and co-author of the textbook, Consumer Health: A Guide to Intelligent Decisions.