A Prospective Study Comparing Celecoxib with Naproxen in Children with Juvenile Rheumatoid Arthritis

Foeldvari, Ivan; Szer, Ilona S.; Zemel, Lawrence; Lovell, Daniel J.; Giannini, Edward H.; Robbins, Jeffery; West, Christine R.; Steidle, Gina; Krishnaswami, Sriram; Bloom, Bradley J.

doi:10.3899/jrheum.080073

Cited by 57 publications

(37 citation statements)

References 23 publications

(18 reference statements)

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“…The usual pediatric dose for juvenile rheumatoid arthritis is 50-100 mg orally, twice daily for children ≥ 2 years-old. Therefore, celecoxib was administered twice a day at a dose of 2.5 mg/kg in this study (Lie and Turner, 2002;Turner and Ford, 2004;Foeldvari et al, 2009). All rats were observed daily for any changes in their general condition.…”

Section: Methodsmentioning

confidence: 99%

Effects of celecoxib in young rats: Histopathological changes in tissues and alterations of oxidative stress/antioxidant defense system

2011

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Celecoxib is increasingly being used in children with rheumatologic complaints. Although the particular concerns about the safety of the drug, there are only a small number of published studies in children. This study was performed to investigate the effects of celecoxib on oxidative stress and antioxidant enzyme activities as well as celecoxib-induced changes in liver, kidneys and stomach of young rats. Four weeks-old Wistar albino, female rats were used. Celecoxib was given by gavage for 14 days. Control rats received only vehicle. Blood and organs were taken under pentobarbital anesthesia. Plasma malondialdehyde levels were increased by treatment. Catalase activity was increased, while glutathione peroxidase activity was decreased. Superoxide dismutase and glucose-6-phosphate dehydrogenase activities was not changed by treatment. The reduced glutathione content of kidneys were higher, while there was no significant difference in liver content, as compared with controls. Significant changes were observed in serum parameters of rats treated with celecoxib. Histopathological evaluation of organs was done by an experienced pathologist unaware of the treatment. Results of the present study indicated the alterations of oxidant/antioxidant status and histopathological changes in tissues of young rats treated with celecoxib.

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Section: Methodsmentioning

confidence: 99%

Effects of celecoxib in young rats: Histopathological changes in tissues and alterations of oxidative stress/antioxidant defense system

2011

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“…Celecoxib was as effective as naproxen in children with juvenile rheumatoid arthritis (Foeldvari et al, 2008 Level II). Small-scale efficacy studies evaluated different perioperative doses of rofecoxib (prior to its withdrawal from the market): low dose (0.625 mg/kg) was inferior to ibuprofen (in combination with paracetamol) (Pickering et al, 2002 Level II); 1 mg/kg was superior to placebo (Joshi et al, 2003 …”

Section: Coxibsmentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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Objectives: This study aimed to assess analgesia provided by acupuncture, alone or in combination with pharmacotherapy, to patients presenting to emergency departments with acute low back pain, migraine or ankle sprain. Design: A pragmatic, multicentre, randomised, assessor‐blinded, equivalence and non‐inferiority trial of analgesia, comparing acupuncture alone, acupuncture plus pharmacotherapy, and pharmacotherapy alone for alleviating pain in the emergency department. Setting, participants: Patients presenting to emergency departments in one of four tertiary hospitals in Melbourne with acute low back pain, migraine, or ankle sprain, and with a pain score on a 10‐point verbal numerical rating scale (VNRS) of at least 4. Main outcome measures: The primary outcome measure was pain at one hour (T1). Clinically relevant pain relief was defined as achieving a VNRS score below 4, and statistically relevant pain relief as a reduction in VNRS score of greater than 2 units. Results: 1964 patients were assessed between January 2010 and December 2011; 528 patients with acute low back pain (270 patients), migraine (92) or ankle sprain (166) were randomised to acupuncture alone (177 patients), acupuncture plus pharmacotherapy (178) or pharmacotherapy alone (173). Equivalence and non‐inferiority of treatment groups was found overall and for the low back pain and ankle sprain groups in both intention‐to‐treat and per protocol (PP) analyses, except in the PP equivalence testing of the ankle sprain group. 15.6% of patients had clinically relevant pain relief and 36.9% had statistically relevant pain relief at T1; there were no between‐group differences. Conclusion: The effectiveness of acupuncture in providing acute analgesia for patients with back pain and ankle sprain was comparable with that of pharmacotherapy. Acupuncture is a safe and acceptable form of analgesia, but none of the examined therapies provided optimal acute analgesia. More effective options are needed. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12609000989246.

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“…The primary analysis of both efficacy Slightly abnormal stance (partial weight-bearing of limb, but paw remains firmly in contact with floor) [2] Markedly abnormal stance (partial weight-bearing of limb, with minimal contact between paw and the floor) [3] Severely abnormal stance (no weight-bearing) Lameness at walk [0] No lameness; normal weight-bearing on all strides observed [1] Mild lameness with partial weight-bearing [2] Obvious lameness with partial weight-bearing [3] Marked lameness with no weight-bearing Lameness at trot [0] No lameness; normal weight-bearing on all strides observed [1] Mild lameness with partial weight-bearing [2] Obvious lameness with partial weight-bearing [3] Marked lameness with no weight-bearing Willingness to allow the clinician to lift the limb contralateral to the affected limb [0] Readily accepts contralateral limb elevation, bears full weight on affected limb for more than 30 sec [1] Offers mild resistance to contralateral limb elevation, bears full weight on affected limb for more than 30 sec [2] Offers moderate resistance to contralateral limb elevation and replaces it in less than 30 sec [3] Offers strong resistance to elevation of contralateral limb and replaces it in less than 10 sec [4] Refuses to raise contralateral limb Pain at palpation/mobilization [0] No pain elicited on palpation/mobilization of affected joint [1] Mild pain elicited, e.g. turns head in recognition [2] Moderate pain elicited, e.g. pulls limb away [3] Severe pain elicited, e.g.…”

Section: Tolerabilitymentioning

confidence: 99%

“…Excellent: no detectable lameness, animal returned to normal activity [1] Good: marked reduction in lameness, but not completely resolved [2] Fair: only slight reduction in lameness [3] Poor: no improvement or condition worsened.…”

Section: Tolerabilitymentioning

confidence: 99%

“…Reciprocals of clinical scores were used so that estimates >1 indicate superior efficacy of robenacoxib. A delta (δ) value of 0.25 was selected, as was used in a recent NSAID clinical trial in children [2], so that noninferiority was concluded if the lower boundary of the The clinician investigator interviewed the owner on days 14 and 28 to record the owners' scores. The global owner score was the sum of the scores for activity, stiffness and lameness.…”

Section: Tolerabilitymentioning

confidence: 99%

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Comparison of Oral Robenacoxib and Carprofen for the Treatment of Osteoarthritis in Dogs: A Randomized Clinical Trial

et al. 2012

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ABSTRACT. The efficacy and tolerability of robenacoxib for the treatment of osteoarthritis in dogs were evaluated in a prospective, multicenter, randomized, noninferiority design clinical trial. A total of 32 dogs presenting with osteoarthritis were allocated randomly to receive, orally once daily for 28 days, either 1-2 mg/kg robenacoxib (n=21) or 3.5-5 mg/kg carprofen (n=11). Dogs were assessed by clinicians and owners using numerical rating scale scores at baseline and days 14 and 28. The primary efficacy endpoint was the global functional disability score, which was the sum of clinician scores for standing posture, lameness at walk, lameness at trot, willingness to raise the contralateral limb and pain at palpation. There was a good to excellent level of efficacy in both treatment groups. Differences between days 14 and 28 compared to day 0 were significant for all 11 clinician and owner scores for robenacoxib, and for 6 of 11 scores for carprofen. The efficacy of robenacoxib was numerically superior to carprofen for all 13 endpoints, but differences were not statistically significant. For the global functional disability score, the estimated efficacy of robenacoxib was 1.244 (95% confidence interval 0.555-2.493) relative to carprofen. The tolerability of both treatments was good as assessed from adverse events, clinical signs, and hematology and serum biochemistry variables. In conclusion, once daily administration of robenacoxib tablets had noninferior efficacy and tolerability compared to carprofen for the treatment of the clinical signs of osteoarthritis in dogs.

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A Prospective Study Comparing Celecoxib with Naproxen in Children with Juvenile Rheumatoid Arthritis

Abstract: Celecoxib 3 mg/kg bid and 6 mg/kg bid were at least as effective as naproxen 7.5 mg/kg bid in treating the signs and symptoms of JRA over 12 weeks. All treatments were generally well tolerated.

Cited by 57 publications

References 23 publications

Effects of celecoxib in young rats: Histopathological changes in tissues and alterations of oxidative stress/antioxidant defense system

Effects of celecoxib in young rats: Histopathological changes in tissues and alterations of oxidative stress/antioxidant defense system

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Comparison of Oral Robenacoxib and Carprofen for the Treatment of Osteoarthritis in Dogs: A Randomized Clinical Trial

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