Efficacy of Etoricoxib, Celecoxib, Lumiracoxib, Non-selective NSAIDs, and Acetaminophen in Osteoarthritis: a Mixed Treatment Comparison

Overview

Journal Open Rheumatol J

Publisher Bentham Open

Specialty Rheumatology

Date 2012 May 15

PMID 22582102

Citations 8

Authors

Wb Stam

Jp Jansen

Sd Taylor

Affiliations

Soon will be listed here.

Abstract

Objective: To compare the efficacy of etoricoxib, lumiracoxib, celecoxib, non-selective (ns) NSAIDs and acetaminophen in the treatment of osteoarthritis (OA) METHODS: Randomized placebo controlled trials investigating the effects of acetaminophen 4000mg, diclofenac 150mg, naproxen 1000mg, ibuprofen 2400mg, celecoxib 100-400mg, lumiracoxib 100-400mg, and etoricoxib 30-60mg with treatment duration of at least two weeks were identified with a systematic literature search. The endpoints of interest were pain, physical function and patient global assessment of disease status (PGADS). Pain and physical function reported on different scales (VAS or LIKERT) were translated into effect sizes (ES). An ES 0.2 - 0.5 was defined as a "small" treatment effect, whereas ES of 0.5 - 0.8 and > 0.8 were defined as "moderate" and "large", respectively. A negative effect indicated superior effects of the treatment group compared to the control group. Results of all trials were analyzed simultaneously with a Bayesian mixed treatment comparison.

Results: There is a >95% probability that etoricoxib (30 or 60mg) shows the greatest improvement in pain and physical function of all interventions compared. ESs of etoricoxib 30mg relative to placebo, celecoxib 200mg, ibuprofen 2400mg, and diclofenac 150mg were -0.66 (95% Credible Interval -0.83; -0.49), -0.32 (-0.50; -0.14), -0.25 (-0.53; 0.03), and -0.17 (-0.41; 0.08), respectively. Regarding physical functioning, ESs of etoricoxib 30mg relative to placebo, celecoxib 200mg, ibuprofen 2400mg, and diclofenac 150mg were -0.61 (-0.76; -0.46), -0.27 (-0.43; -0.10), -0.20 (-0.47; 0.07), and -0.09 (- 0.33; 0.14) respectively. The greatest improvements in PGADS were expected with either etoricoxib or diclofenac.

Conclusion: The current study estimated the efficacy of acetaminophen, nsNSAIDs, and COX-2 selective NSAIDs in OA and found that etoricoxib 30 mg is likely to result in the greatest improvements in pain and physical function. Differences in PGADS between interventions were smaller.

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References

Callahan L . The burden of rheumatoid arthritis: facts and figures. J Rheumatol Suppl. 1998; 53:8-12. View

Smugar S, Schnitzer T, Weaver A, Rubin B, Polis A, Tershakovec A . Rofecoxib 12.5 mg, rofecoxib 25 mg, and celecoxib 200 mg in the treatment of symptomatic osteoarthritis: results of two similarly designed studies. Curr Med Res Opin. 2006; 22(7):1353-67. DOI: 10.1185/030079906X104876. View

Jansen J, Fleurence R, Devine B, Itzler R, Barrett A, Hawkins N . Interpreting indirect treatment comparisons and network meta-analysis for health-care decision making: report of the ISPOR Task Force on Indirect Treatment Comparisons Good Research Practices: part 1. Value Health. 2011; 14(4):417-28. DOI: 10.1016/j.jval.2011.04.002. View

Schnitzer T, Weaver A, Polis A, Petruschke R, Geba G . Efficacy of rofecoxib, celecoxib, and acetaminophen in patients with osteoarthritis of the knee. A combined analysis of the VACT studies. J Rheumatol. 2005; 32(6):1093-105. View

Gibofsky A, Williams G, McKenna F, Fort J . Comparing the efficacy of cyclooxygenase 2-specific inhibitors in treating osteoarthritis: appropriate trial design considerations and results of a randomized, placebo-controlled trial. Arthritis Rheum. 2003; 48(11):3102-11. DOI: 10.1002/art.11330. View

Sheldon E, Beaulieu A, Paster Z, Dutta D, Yu S, Sloan V . Efficacy and tolerability of lumiracoxib in the treatment of osteoarthritis of the knee: a 13-week, randomized, double-blind comparison with celecoxib and placebo. Clin Ther. 2005; 27(1):64-77. DOI: 10.1016/j.clinthera.2005.01.002. View

Pincus T, Koch G, Lei H, Mangal B, Sokka T, Moskowitz R . Patient Preference for Placebo, Acetaminophen (paracetamol) or Celecoxib Efficacy Studies (PACES): two randomised, double blind, placebo controlled, crossover clinical trials in patients with knee or hip osteoarthritis. Ann Rheum Dis. 2004; 63(8):931-9. PMC: 1755088. DOI: 10.1136/ard.2003.020313. View

Williams G, Hubbard R, Yu S, Zhao W, Geis G . Comparison of once-daily and twice-daily administration of celecoxib for the treatment of osteoarthritis of the knee. Clin Ther. 2001; 23(2):213-27. DOI: 10.1016/s0149-2918(01)80004-7. View

Lehmann R, Brzosko M, Kopsa P, Nischik R, Kreisse A, Thurston H . Efficacy and tolerability of lumiracoxib 100 mg once daily in knee osteoarthritis: a 13-week, randomized, double-blind study vs. placebo and celecoxib. Curr Med Res Opin. 2005; 21(4):517-26. DOI: 10.1185/030079905x38196. View

10.

Bensen W, Fiechtner J, McMillen J, Zhao W, Yu S, Woods E . Treatment of osteoarthritis with celecoxib, a cyclooxygenase-2 inhibitor: a randomized controlled trial. Mayo Clin Proc. 1999; 74(11):1095-105. DOI: 10.4065/74.11.1095. View

11.

Williams G, Ettlinger R, Ruderman E, Hubbard R, Lonien M, Yu S . Treatment of osteoarthritis with a once-daily dosing regimen of celecoxib: a randomized, controlled trial. J Clin Rheumatol. 2008; 6(2):65-74. DOI: 10.1097/00124743-200004000-00002. View

12.

Wiesenhutter C, Boice J, Ko A, Sheldon E, Murphy F, Wittmer B . Evaluation of the comparative efficacy of etoricoxib and ibuprofen for treatment of patients with osteoarthritis: A randomized, double-blind, placebo-controlled trial. Mayo Clin Proc. 2005; 80(4):470-9. DOI: 10.4065/80.4.470. View

13.

Case J, Baliunas A, Block J . Lack of efficacy of acetaminophen in treating symptomatic knee osteoarthritis: a randomized, double-blind, placebo-controlled comparison trial with diclofenac sodium. Arch Intern Med. 2003; 163(2):169-78. DOI: 10.1001/archinte.163.2.169. View

14.

Lee C, Hunsche E, Balshaw R, Kong S, Schnitzer T . Need for common internal controls when assessing the relative efficacy of pharmacologic agents using a meta-analytic approach: case study of cyclooxygenase 2-selective inhibitors for the treatment of osteoarthritis. Arthritis Rheum. 2005; 53(4):510-8. DOI: 10.1002/art.21328. View

15.

Bellamy N, Kirwan J, Boers M, Brooks P, Strand V, Tugwell P . Recommendations for a core set of outcome measures for future phase III clinical trials in knee, hip, and hand osteoarthritis. Consensus development at OMERACT III. J Rheumatol. 1997; 24(4):799-802. View

16.

Towheed T, Maxwell L, Judd M, Catton M, Hochberg M, Wells G . Acetaminophen for osteoarthritis. Cochrane Database Syst Rev. 2006; (1):CD004257. PMC: 8275921. DOI: 10.1002/14651858.CD004257.pub2. View

17.

McKenna F, Borenstein D, Wendt H, Wallemark C, Lefkowith J, Geis G . Celecoxib versus diclofenac in the management of osteoarthritis of the knee. Scand J Rheumatol. 2001; 30(1):11-8. DOI: 10.1080/030097401750065265. View

18.

Puopolo A, Boice J, Fidelholtz J, Littlejohn T, Miranda P, Berrocal A . A randomized placebo-controlled trial comparing the efficacy of etoricoxib 30 mg and ibuprofen 2400 mg for the treatment of patients with osteoarthritis. Osteoarthritis Cartilage. 2007; 15(12):1348-56. DOI: 10.1016/j.joca.2007.05.022. View

19.

Pincus T, Koch G, Sokka T, Lefkowith J, Wolfe F, Jordan J . A randomized, double-blind, crossover clinical trial of diclofenac plus misoprostol versus acetaminophen in patients with osteoarthritis of the hip or knee. Arthritis Rheum. 2001; 44(7):1587-98. DOI: 10.1002/1529-0131(200107)44:7<1587::AID-ART282>3.0.CO;2-X. View

20.

Sarzi-Puttini P, Cimmino M, Scarpa R, Caporali R, Parazzini F, Zaninelli A . Osteoarthritis: an overview of the disease and its treatment strategies. Semin Arthritis Rheum. 2005; 35(1 Suppl 1):1-10. DOI: 10.1016/j.semarthrit.2005.01.013. View