DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20183939

A comparative study to assess the safety and efficacy of etoricoxib versus aceclofenac in osteoarthritis

Harsimrat S. Waraich, Vikas Kumar, Ashok Goel, Jatinder Singh

Abstract


Background: Osteoarthritis (OA) is most common form of arthritis; also referred as degenerative joint disease or “wear and tear” arthritis. Cyclooxygenase-2 (COX-2) inhibitors are effective for pain and inflammation in OA and gained importance over conventional non-steroidal anti-inflammatory agents (NSAIDs), as causes significantly less toxicity, particularly, in gastrointestinal tract. The objective of the present research was to study the short-term comparative clinical efficacy of aceclofenac and etoricoxib in patients with osteoarthritis and to compare the safety profile of the two drugs i.e. aceclofenac and etoricoxib.

Methods: The present study was a prospective, open label, parallel, intention to treat 80 patients out of 102 screened for osteoarthritis in the Department of Orthopaedics, Guru Nanak Dev Hospital attached to the Government Medical College, Amritsar. Patients were randomly divided in two groups with 40 patients each. Group A patients received Tab etoricoxib 60mg once daily and Group B patients received Tab. Aceclofenac 100mg twice daily. Patients were followed up after three weeks and at six weeks for clinical efficacy and safety.

Results: Both the groups found to have significant improvement in signs and symptoms of osteoarthritis. However, aceclofenac was superior to etoricoxib in terms of change in visual analogue scale score, osteoarthritic severity index, patients’ and physicians’ global assessment while, etoricoxib was superior in terms of WOMAC osteoarthritic index and safety parameters in terms of ADR.

Conclusions: Etoricoxib was better than conventional NSAIDs for the symptomatic management of osteoarthritis in terms of safety profile and clinical efficacy.


Keywords


Aceclofenac, Etoricoxib, Osteoarthritis, VAS, WOMAC

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References


Osteoarthritis. Basics Arthritis. CDC. Available at: https://www.cdc.gov/arthritis/basics/osteoarthritis.htm. Accessed on Dec 27, 2017.

WHO. Chronic rheumatic conditions. WHO. Available at: http://www.who.int/chp/topics/rheumatic/en/.

Arthritis-India. Available at: http://www.arthritis-india.com/osteoarthritis.html. Accessed on Dec 27, 2017.

Diseases and Conditions Osteoarthritis. Available at: https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Osteoarthritis.

Osteoarthritis Treatment Information. Available at: https://www.hopkinsarthritis.org/arthritis-info/osteoarthritis/oa-treatments/. Accessed on Dec 27, 2017.

Kasper DL, Harrison TR, editors. Harrison´s principles of internal medicine /eds Dennis L. Kasper. Disease pathogenesis and treatment: chapters 99-480. 19th Ed. New York, NY: McGraw Hill Education; 2015(2):467.

Goodman LS, Brunton LL, Chabner B, Knollmann BC, editors. Goodman and Gilman’s pharmacological basis of therapeutics. 12th Ed. New York: McGraw-Hill;2011:2084.

Hawkey CJ. COX-1 and COX-2 inhibitors. Best Pract Res Clin Gastroenterol. 2001 Oct 1;15(5):801-20.

Urban MK. COX-2 specific inhibitors offer improved advantages over traditional NSAIDs. Orthopedics. 2000 Jul;23(7 Suppl):S761-764.

Deeks JJ, Smith LA, Bradley MD. Efficacy, tolerability, and upper gastrointestinal safety of celecoxib for treatment of osteoarthritis and rheumatoid arthritis: systematic review of randomised controlled trials. BMJ. 2002 Sep 21;325(7365):619.

Bingham CO, Sebba AI, Rubin BR, Ruoff GE, Kremer J, Bird S, et al. Efficacy and safety of etoricoxib 30 mg and celecoxib 200 mg in the treatment of osteoarthritis in two identically designed, randomized, placebo-controlled, non-inferiority studies. Rheumatol Oxf Engl. 2007 Mar;46(3):496-507.

Curtis SP, Bockow B, Fisher C, Olaleye J, Compton A, Ko AT, et al. Etoricoxib in the treatment of osteoarthritis over 52-weeks: a double-blind, active-comparator controlled trial (NCT00242489). BMC Musculoskelet Disord. 2005 Dec 1;6:58.

Eginster JY, Malmstrom K, Mehta A, Bergman G, Ko AT, Curtis SP, et al. Evaluation of the efficacy and safety of etoricoxib compared with naproxen in two, 138-week randomised studies of patients with osteoarthritis. Ann Rheum Dis. 2007 Jul 1;66(7):945-51.

Puopolo A, Boice JA, Fidelholtz JL, Littlejohn TW, Miranda P, Berrocal A, et al. 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 Dec;15(12):1348-56.

Stam W, Jansen J, Taylor S. Efficacy of Etoricoxib, celecoxib, lumiracoxib, non-selective NSAIDs, and acetaminophen in osteoarthritis: a mixed treatment comparison. Open Rheumatol J. 2012 Apr 3;6:6-20.

Chalini S, Raman U. Comparative efficacy of aceclofenac and etoricoxib in post extraction pain control: randomized control trial. Indian J Dent Res Off Publ Indian Soc Dent Res. 2005 Jun;16(2):47-50.

Gottesdiener K, Schnitzer T, Fisher C, Bockow B, Markenson J, Ko A, et al. Results of a randomized, dose‐ranging trial of etoricoxib in patients with osteoarthritis. Rheumatol. 2002 Sep 1;41(9):1052-61.

Vohra F, Raut A. Comparative efficacy, safety, and tolerability of diclofenac and aceclofenac in musculoskeletal pain management: a systematic review. Indian J Pain. 2016 Jan 1;30(1):3.

Batlle-Gualda E, Román Ivorra J, Martín-Mola E, Carbonell Abelló J, Linares Ferrando LF, Tornero Molina J, et al. Aceclofenac vs paracetamol in the management of symptomatic osteoarthritis of the knee: a double-blind 6-week randomized controlled trial. Osteoarthritis Cartilage. 2007 Aug;15(8):900-8.

Baraf HSB, Fuentealba C, Greenwald M, Brzezicki J, O’Brien K, Soffer B, et al. Gastrointestinal side effects of etoricoxib in patients with osteoarthritis: results of the etoricoxib versus diclofenac sodium gastrointestinal tolerability and effectiveness (EDGE) trial. J Rheumatol. 2007 Feb;34(2):408-20.