The Pharmaceutical Journal
Vol 269 No 7213 p273
31 August 2002

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Journal of Rheumatology article (more)

Etoricoxib more effective than naproxen for rheumatoid arthritis

The new cyclo-oxygenase-2 inhibitor Etoricoxib (Arcoxia) is more effective than naproxen for treating patients with rheumatoid arthritis, a study shows. Etoricoxib was launched earlier this year.

American researchers say that the superior efficacy of etoricoxib over naproxen, and placebo, was consistently observed over a range of measures, including tender and swollen joint counts and assessments of pain, inflammation, physical function and global disease activity. They add that etoricoxib was generally well tolerated in patients with rheumatoid arthritis.

They randomly assigned 816 patients who were chronic users of non-steroidal anti-inflammatory drugs to receive etoricoxib 90mg once daily, naproxen 500mg twice daily or placebo, for 12 weeks. Of these patients, 230 in the etoricoxib group (71.2 per cent), 96 in the naproxen group (55.2 per cent) and 122 taking placebo (37.8 per cent) completed the trial.

The most common reason for discontinuation was lack of efficacy and more patients in the naproxen group (36.5 per cent) and placebo group (54.5 per cent) discontinued for this reason than in the etoricoxib group (21. 7 per cent) (P<0.01 for etoricoxib versus placebo and naproxen).

Drug-related adverse events occurred most frequently in the digestive system, with patients in the naproxen group experiencing slightly higher incidences of dyspepsia, heartburn and nausea than patients in the other groups. The researchers conclude that the reason for etoricoxib's superior efficacy is unclear, as is whether or not the finding is a unique feature of the population studied (Journal of Rheumatology 2002;29: 1623). The study was funded by Merck Research Laboratories.