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New directions in symptomatic therapy for patients with osteoarthritis and rheumatoid arthritis.
Semin Arthritis Rheum. 2002 Dec; 32(3 Suppl 1):4-14.SA

Abstract

The cyclooxygenase (COX)-2-selective nonsteroidal anti-inflammatory drugs (NSAIDs; coxibs) were developed in order to reduce upper gastrointestinal (GI) side effects associated with traditional nonselective NSAIDs. This article presents an overview of clinical trials showing the efficacy of coxibs for the treatment of patients with arthritis. In osteoarthritis trials, coxibs were more effective than placebo and similarly effective compared with standard doses of traditional NSAIDs. Some studies lasted up to a year and showed effectiveness of coxibs for long-term treatment of patients with osteoarthritis. There are currently few adequately powered trials comparing the efficacy of the 2 first-generation coxibs, celecoxib and rofecoxib. Of 2 head-to-head studies comparing the 2 agents, 1 indicated similar efficacy, whereas the other showed the superiority of rofecoxib at a dose of 25 mg daily compared with celecoxib at a dose of 200 mg daily. In studies enrolling patients with rheumatoid arthritis, coxibs also have shown efficacy superior to that of placebo and similar to that of traditional NSAIDs. There are no clinical trials comparing the efficacy of different coxibs for treatment of patients with rheumatoid arthritis. In endoscopic studies, the GI safety and tolerability profile of coxibs has been consistently superior to that of traditional NSAIDs. In large clinical outcome trials, at least 1 of the coxibs, rofecoxib, significantly reduced the risk of confirmed complicated upper GI events compared with the conventional NSAID naproxen. Both rofecoxib and celecoxib reduced the risk of confirmed clinical upper GI events compared with the nonselective NSAIDs naproxen and ibuprofen in patients with osteoarthritis and rheumatoid arthritis not taking low-dose aspirin. Therefore, coxibs provide effective relief of pain from osteoarthritis and rheumatoid arthritis, with efficacy that is comparable to traditional NSAIDs, but with a significantly lower incidence of GI complications.

Authors+Show Affiliations

Department of Medicine and Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

12528069

Citation

Hochberg, Marc C.. "New Directions in Symptomatic Therapy for Patients With Osteoarthritis and Rheumatoid Arthritis." Seminars in Arthritis and Rheumatism, vol. 32, no. 3 Suppl 1, 2002, pp. 4-14.
Hochberg MC. New directions in symptomatic therapy for patients with osteoarthritis and rheumatoid arthritis. Semin Arthritis Rheum. 2002;32(3 Suppl 1):4-14.
Hochberg, M. C. (2002). New directions in symptomatic therapy for patients with osteoarthritis and rheumatoid arthritis. Seminars in Arthritis and Rheumatism, 32(3 Suppl 1), 4-14.
Hochberg MC. New Directions in Symptomatic Therapy for Patients With Osteoarthritis and Rheumatoid Arthritis. Semin Arthritis Rheum. 2002;32(3 Suppl 1):4-14. PubMed PMID: 12528069.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - New directions in symptomatic therapy for patients with osteoarthritis and rheumatoid arthritis. A1 - Hochberg,Marc C, PY - 2003/1/16/pubmed PY - 2003/4/2/medline PY - 2003/1/16/entrez SP - 4 EP - 14 JF - Seminars in arthritis and rheumatism JO - Semin Arthritis Rheum VL - 32 IS - 3 Suppl 1 N2 - The cyclooxygenase (COX)-2-selective nonsteroidal anti-inflammatory drugs (NSAIDs; coxibs) were developed in order to reduce upper gastrointestinal (GI) side effects associated with traditional nonselective NSAIDs. This article presents an overview of clinical trials showing the efficacy of coxibs for the treatment of patients with arthritis. In osteoarthritis trials, coxibs were more effective than placebo and similarly effective compared with standard doses of traditional NSAIDs. Some studies lasted up to a year and showed effectiveness of coxibs for long-term treatment of patients with osteoarthritis. There are currently few adequately powered trials comparing the efficacy of the 2 first-generation coxibs, celecoxib and rofecoxib. Of 2 head-to-head studies comparing the 2 agents, 1 indicated similar efficacy, whereas the other showed the superiority of rofecoxib at a dose of 25 mg daily compared with celecoxib at a dose of 200 mg daily. In studies enrolling patients with rheumatoid arthritis, coxibs also have shown efficacy superior to that of placebo and similar to that of traditional NSAIDs. There are no clinical trials comparing the efficacy of different coxibs for treatment of patients with rheumatoid arthritis. In endoscopic studies, the GI safety and tolerability profile of coxibs has been consistently superior to that of traditional NSAIDs. In large clinical outcome trials, at least 1 of the coxibs, rofecoxib, significantly reduced the risk of confirmed complicated upper GI events compared with the conventional NSAID naproxen. Both rofecoxib and celecoxib reduced the risk of confirmed clinical upper GI events compared with the nonselective NSAIDs naproxen and ibuprofen in patients with osteoarthritis and rheumatoid arthritis not taking low-dose aspirin. Therefore, coxibs provide effective relief of pain from osteoarthritis and rheumatoid arthritis, with efficacy that is comparable to traditional NSAIDs, but with a significantly lower incidence of GI complications. SN - 0049-0172 UR - https://www.unboundmedicine.com/medline/citation/12528069/New_directions_in_symptomatic_therapy_for_patients_with_osteoarthritis_and_rheumatoid_arthritis_ DB - PRIME DP - Unbound Medicine ER -