Comparison of the efficacy and safety of oxaprozin and nabumetone in the treatment of patients with osteoarthritis of the knee

Weaver, Arthur L.; Rubin, Bernard; Caldwell, Jacques R.; McMahon, F. Gilbert; Lee, David; Makarowski, William; Offenberg, Howard L.; Sack, Marshall; Sikes, David; Trapp, Robert G.; Rush, Susan M.; Kuss, Michael; Ganju, Jitendra; Bocanegra, Tomás S.

doi:10.1016/0149-2918(95)80050-6

Cited by 26 publications

(12 citation statements)

References 7 publications

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“…There were more women (67.9%) than men, and the median duration of symptoms was 8.2 years. The weighted mean baseline pain of 64.1 mm on a visual analogue scale was calculated from all but three trials 37 51 52. Six reports provided data of body mass index with a median mean value of 31.2 32 35 38 43 44 48.…”

Section: Resultsmentioning

confidence: 99%

Non-steroidal anti-inflammatory drugs, including cyclo-oxygenase-2 inhibitors, in osteoarthritic knee pain: meta-analysis of randomised placebo controlled trials

Bjordal

Ljunggren

Klovning

et al. 2004

BMJ

391

221

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Objective To estimate the analgesic efficacy of non-steroidal anti-inflammatory drugs (NSAIDs), including selective cyclo-oxygenase-2 inhibitors (coxibs), in patients with osteoarthritis of the knee. Design Systematic review and meta-analysis of randomised placebo controlled trials. Studies reviewed 23 trials including 10 845 patients, median age of 62.5 years. 7807 patients received adequate doses of NSAIDs and 3038 received placebo. The mean weighted baseline pain score was 64.2 mm on 100 mm visual analogue scale (VAS), and average duration of symptoms was 8.2 years. Main outcome measure Change in overall intensity of pain. Results Methodological quality of trials was acceptable, but 13 trials excluded patients before randomisation if they did not respond to NSAIDs. One trial provided long term data for pain that showed no significant effect of NSAIDs compared with placebo at one to four years. The pooled difference for pain on visual analogue scale in all included trials was 10.1 mm (95% confidence interval 7.4 to 12.8) or 15.6% better than placebo after 2-13 weeks. The results were heterogeneous, and the effect size for pain reduction was 0.32 (0.24 to 0.39) in a random effects model. In 10 trials that did not exclude non-responders to NSAID treatment the results were homogeneous, with an effect size for pain reduction of 0.23 (0.15 to 0.31). Conclusion NSAIDs can reduce short term pain in osteoarthritis of the knee slightly better than placebo, but the current analysis does not support long term use of NSAIDs for this condition. As serious adverse effects are associated with oral NSAIDs, only limited use can be recommended.

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Section: Resultsmentioning

confidence: 99%

Non-steroidal anti-inflammatory drugs, including cyclo-oxygenase-2 inhibitors, in osteoarthritic knee pain: meta-analysis of randomised placebo controlled trials

Bjordal

Ljunggren

Klovning

et al. 2004

BMJ

391

221

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show abstract

“…Thirteen trials of oral NSAIDs (Weaver et al, 1995;Makarowski et al, 1996;Simon et al, 1998;Bensen et al, 1999;Zhao et al, 1999a;Ehrich et al, 2001;McKenna et al, 2001a,b;Williams et al, 2001;Gottesdiener et al, 2002;Case et al, 2003;Gibofsky et al, 2003;Kivitz et al, 2004) and one trial of topical NSAID gel (Grace et al, 1999) employed an additional criterion by requiring a predefined minimum flare of symptoms when oral paracetamol or NSAID treatment was discontinued for pretreatment wash-out. Females dominated at 63.2%.…”

Section: Included Studiesmentioning

confidence: 99%

“…For efficacy analysis at weeks 6-12 after start of therapy, follow-up data were available from 3 trials of paracetamol (Case et al, 2003;Miceli-Richard et al, 2004;Pincus and Koch, 2004), 14 trials of oral NSAIDs (Lee et al, 1985;Weaver et al, 1995;Bensen et al, 1999;Zhao et al, 1999b;Ehrich et al, 2001;McKenna et al, 2001a,b;Gottesdiener et al, 2002;Kivitz et al, 2002;Gibofsky et al, 2003;Kivitz et al, 2004;Tannenbaum et al, 2004;Lehmann et al, 2005;Sheldon et al, 2005), 5 trials of steroid injections (Friedman and Moore, 1980;Gaffney et al, 1995;Jones et al, 1995;Ravaud et al, 1999;Smith et al, 2003), and from a single trial of topical NSAIDs (Bookman et al, 2004). For paracetamol, efficacy did not change during the followup period, and corresponded to 4.0 mm [95% CI 1.1-6.9] on VAS at week 12.…”

Section: Secondary Outcome -Time-effect Profilesmentioning

confidence: 99%

Short‐term efficacy of pharmacotherapeutic interventions in osteoarthritic knee pain: A meta‐analysis of randomised placebo‐controlled trials

Bjordal

Klovning

Ljunggren

et al. 2007

European Journal of Pain

256

170

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“…Why patients might respond to one agent and not another remains unclear. Because interruption of Cox-1, which is common to essentially all NSAIDs, results in blockade of essential gastrointestinal tract tissue protection, all NSAIDs are associated with an increased risk of gastrointestinal bleeding 27–31. Cox-2 inhibition should not be viewed as an absolute category; isoform selectivity for Cox-2 selection is not an absolute but rather a continuous discrete variable.…”

Section: Is There Any Difference Between the Nsaids Available?mentioning

confidence: 99%

Nonsteroidal anti-inflammatory drugs in the treatment of low back pain

Kuritzky¹,

Samraj²

2012

JPR

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Low back pain (LBP) is amongst the top ten most common conditions presenting to primary care clinicians in the ambulatory setting. Further, it accounts for a significant amount of health care expenditure; indeed, over one third of all disability dollars spent in the United States is attributable to low back pain. In most cases, acute low back pain is a self-limiting disease. There are many evidence-based guidelines for the management of LBP. The most common risk factor for development of LBP is previous LBP, heavy physical work, and psychosocial risk factors. Management of LBP includes identification of red flags, exclusion of specific secondary causes, and comprehensive musculoskeletal/neurological examination of the lower extremities. In uncomplicated LBP, imaging is unnecessary unless symptoms become protracted. Reassurance that LBP will likely resolve and advice to maintain an active lifestyle despite LBP are the cornerstones of management. Medications are provided not because they change the natural history of the disorder, but rather because they enhance the ability of the patient to become more active, and in some cases, to sleep better. The most commonly prescribed medications include nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants. Although NSAIDs are a chemically diverse class, their similarities, efficacy, tolerability, and adverse effect profile have more similarities than differences. The most common side effects of NSAIDs are gastrointestinal. Agents with cyclo-oxygenase 2 selectivity are associated with reduced gastrointestinal bleeding, but problematic increases in adverse cardiovascular outcomes continue to spark concern. Fortunately, short-term use of NSAIDs for LBP is generally both safe and effective. This review will focus on the role of NSAIDs in the management of LBP.

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Comparison of the efficacy and safety of oxaprozin and nabumetone in the treatment of patients with osteoarthritis of the knee

Cited by 26 publications

References 7 publications

Non-steroidal anti-inflammatory drugs, including cyclo-oxygenase-2 inhibitors, in osteoarthritic knee pain: meta-analysis of randomised placebo controlled trials

Non-steroidal anti-inflammatory drugs, including cyclo-oxygenase-2 inhibitors, in osteoarthritic knee pain: meta-analysis of randomised placebo controlled trials

Short‐term efficacy of pharmacotherapeutic interventions in osteoarthritic knee pain: A meta‐analysis of randomised placebo‐controlled trials

Nonsteroidal anti-inflammatory drugs in the treatment of low back pain

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