Arthritis relief greater with rofecoxib than with paracetamol
or celecoxib
Rofecoxib (Vioxx) has benefits over paracetamol and
celecoxib (Celebrex) in reducing the symptoms of osteoarthritis of the
knee, a new study indicates.
Dr Gregory Geba, Merck & Co (manufacture of
Vioxx and sponsors of the study), West Point, Pennsylvania, and colleagues
randomised 382 patients with osteoarthritis of the knee to receive one
of the following treatment regimens for six weeks: rofecoxib 25mg daily,
rofecoxib 12.5mg daily, celecoxib 200mg daily or paracetamol 4g daily.
Patients were at least 40 years old and had previously been treated with
non-steroidal anti-inflammatory drugs or paracetamol.
The researchers found that in the first six days
of treatment, efficacy, as measured using a visual analogue scale (the
Western Ontario McMaster Universities Osteoarthritis Index), was greatest
for rofecoxib 25mg daily, followed by rofecoxib 12.5mg daily, celecoxib
and paracetamol. Over the six days, the average decrease in the scores
for pain on walking, pain at rest and morning stiffness were greatest
for rofecoxib 25mg daily and smallest for paracetamol. These trends continued
over the six-week trial period.
"It is possible that a higher dose of celecoxib
would have resulted in greater efficacy although previous studies have
demonstrated that 200mg daily is the dose level that provides maximal
efficacy in OA," the researchers say (JAMA 2002;287:64).
A spokeswoman for Pharmacia, manufacturer of Celebrex,
told The Journal that data from the study had showed comparable
efficacy of celecoxib and rofecoxib when criteria previously published
by Merck were used. She also pointed out that results from the study confirm
the high incidence of cardiovascular side effects associated with rofecoxib.
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