Comparative study of effectiveness and safety of nonsteroidal anti-inflammatory drugs in patients of knee joint osteoarthritis of knee, tertiary care hospital, Bidar, India

Vivekanand ., G. P. Kulkarni


Background: Osteoarthritis (OA) is a joint failure and OA is the most frequent chronic joint disease causing pain and disability. Where all the structures of joints have undergone pathological changes and they are hyaline articular cartilage loss which may be focal or non-uniform, initially it will be focal then spread all over non-uniformly. Non-Steroidal Anti Inflammatory Drugs (NSAID) are the mainstay of medical management of OA. Increased in reports suggests that GIT adverse effect with old NSAID’s and cardiovascular effects with selective cyclooxygenase-2 (COX2) inhibitors had precipitated to chase for better NSAID’s with minimal adverse effects. The current study compares the clinical effectiveness and safety of newer NSAID’s, etoricoxib, lornoxicam, to diclofenac which has been standard therapy in patients of OA of the knee joint.

Methods: The current study is randomized, prospective, open-label, parallel group study conducted in 120 patients with OA of the knee joint diagnosed using American College of Rheumatology criteria. After getting the informed consent, they were randomized in three groups of 40 patients each who received tablet etoricoxib 120mg BID, tablet Lornoxicam 16mg BID, tablet diclofenac 50mg TID respectively. The duration of the study is 12 weeks. Data are calculated, tabulated and analyzed using analysis of variance (ANOVA) test, and level of significance was determined by its P value.

Results: After 12weeks of treatment, the severity of pain and functional indices using visual analog scale and Western Ontario and McMaster Universities Osteoarthritis score were significantly better (P <0.05) in etoricoxib group as compared to lornoxicam or diclofenac group along with a lesser rate of adverse effects.

Conclusions: It is concluded that etoricoxib is more effective and tolerated NSAID than lornoxicam and diclofenac in the treatment of knee joint OA.


Diclofenac, Etoricoxib, Lornoxicam, VAS, WOMAC Score

Full Text:



Sarıdoğan ME. Cerrahpaşa Medical Faculty, Continuing Medical Education Activities Rheumatic diseases Symposium Series. 2003;34:11‑8.

Creamer P, Hochberg MC. Osteoarthritis. Lancet. 1997;350:5038.

Brandt KD. Osteoarthritis. Clin Geriatr Med. 1988;4:279‑93.

Baker JF, Walsh P, Mulhall KJ. Statins: a potential role in the management of osteoarthritis?. Joint Bone Spine. 2011 Jan 1;78(1):31-4.

Verbruggen G. Chondroprotective drugs in degenerative joint diseases. Rheumatology (Oxford). 2006 Feb;45(2):129-38.

Fawaz‑Estrup F. The osteoarthritis initiative: an overview. Med Health R I. 2004 Jun;87(6):169-71.

Settipane GA. Aspirin and allergic diseases: a review. Am J Med. 1983 Jun 14;74(6):102-9.

Vadgama VK, Gharia R, Mehta K, Tripathi CB. A randomized controlled clinical trial comparing efficacy safety and cost effectiveness of lornoxicam with diclofenac sodium in patients of osteoarthritis knee. Internet J Med Update. 2011;6(2):25‑9.

Kidd B, Frenzel W. A multicenter, randomized, double blind study comparing lornoxicam with diclofenac in osteoarthritis. J Rheumatol. 1996 Sep;23(9):1605-11.

Goregaonkar A, Mathiazhagan KJ, Shah RR, Kapoor PS, Taneja P, Sharma A, et al. Comparative assessment of the effectiveness and tolerability of lornoxicam 8 mg BID and diclofenac 50 mg TID in adult indian patients with osteoarthritis of the hip or knee: a 4-week, double-blind, randomized, comparative, multicenter study. Curr Therap Res. 2009 Feb 1;70(1):56-68.

Karbowski A. Double-blind, parallel comparison of etodolac and indomethacin in patients with osteoarthritis of the knee. Curr Med Res Opin. 1991 Jan 1;12(5):309-17.

Gomes Freitas G. A double-blind comparison of etodolac and piroxicam in the treatment of osteoarthritis. Curr Med Res Opin. 1990 Jan 1;12(4):255-62.

Singh G, Triadafilopoulos G. Epidemiology of NSAID induced gastrointestinal complications. J Rheumatol Suppl. 1999 Apr;56:18-24.