First, we focused on safety outcomes rather than effectiveness. Askling has received consulting fees (less than $10,000 each) from Bristol‐Myers Squibb and Merck Sharp & Dohme.Copenhagen University Hospital, Frederiksberg, DenmarkUse the link below to share a full-text version of this article with your friends and colleagues.
After adjusting for potential confounders, the risk for atherosclerotic events remained significantly increased only for cardiac events in the subgroup of SpA patients (Table The results present risks for outcome events related to nonselective NSAIDs, etoricoxib, and celecoxib that are in the range of what would be anticipated in a group of patients with systemic inflammatory disease The limited power in our study hampers the possibilities to exclude smaller risk differences between the different types of NSAIDs. Pain and physical function reported on different scales (VAS or LIKERT) were translated into effect sizes (ES). This is in contrast to what has been reported from RCTs and meta‐analyses and is likely due to a conscious clinical choice by the treating physicians An evident advantage of the study is the use of nationwide data on all AS and SpA patients diagnosed in inpatient and specialist outpatient care in Sweden, which provides a large sample size while at the same time minimizing the risk for selection bias.
To compare the efficacy of etoricoxib, lumiracoxib, celecoxib, non-selective (ns) NSAIDs and acetaminophen in the treatment of osteoarthritis (OA)Randomized placebo controlled trials investigating the effects of acetaminophen 4000mg, diclofenac 150mg, naproxen 1000mg, ibuprofen 2400mg, celecoxib 100-400mg, lumiracoxib 100-400mg, and etoricoxib 30-60mg with treatment duration of at least two weeks were identified with a systematic literature search.
The greatest improvements in PGADS were expected with either etoricoxib or diclofenac.The current study estimated the efficacy of acetaminophen, nsNSAIDs, and COX-2 selective NSAIDs in OA and found that etoricoxib 30 mg is likely to result in the greatest improvements in pain and physical function. The number of days exposed were standardized according to official defined daily doses (DDDs), defined by World Health Organization standard of exposure as the assumed average maintenance dose per day for a drug used for its main indication in adults Exposure to etoricoxib or nonselective NSAID treatment was analyzed in a time‐dependent manner, i.e., from the first date of dispensing during the study period or for periods determined by the calculated DDDs for the specific prescription, respectively. Moreover, various sensitivity analyses were performed for the following groups: prevalent or registry incident cases (with or without diagnosis prior to study start, i.e., January 1, 2006), AS and SpA patients, adding extra exposure time (plus 14, 30, and 90 days), excluding naproxen exposure for the atherosclerotic events, and analyzing patients with recent outcomes (within 2 years prior to entry) (see Results and Supplementary Table A total of 21,872 patients with AS or SpA met the inclusion criteria. ficacy of etoricoxib 30 mg was comparable to ibuprofen 2400 mg. All treatments were similarly well tolerated.
Etoricoxib was dominant over all time horizons. Jacobsson has received consulting fees and/or speaking fees (less than $10,000 each) from Pfizer, AbbVie, and Merck Sharp & Dohme.Dr. Furthermore, a high degree of confounding by indication, or in clinical terms, selection of patients to/away from treatment with different NSAIDs but in accordance with what is known about their side effect profiles, was present. If exposure periods overlapped, the first period was censored at a new dispensing. Kristensen has received consulting fees and/or speaking fees (less than $10,000 each) from Pfizer, AbbVie, and Merck Sharp & Dohme.Dr.
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