Cyclooxygenase-2 selective non-steroidal anti-inflammatory drugs (etodolac, meloxicam, celecoxib, rofecoxib, etoricoxib, valdecoxib and lumiracoxib) for osteoarthritis and rheumatoid arthritis: a systematic review and economic evaluation

Abstract

Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. NHS libraries can subscribe free of charge. Public libraries can subscribe at a very reduced cost of £100 for each volume (normally comprising 30-40 titles). The commercial subscription rate is £300 per volume. Please see our website for details. Subscriptions can only be purchased for the current or forthcoming volume. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. Declared competing interests of authors: P Jobanputra has received funding from Pfizer for two research studies: 'quality of care in patients with musculoskeletal pain who use NSAIDs' and 'perception of risk in relation to NSAID use for patients with RA and OA'. He has also been entertained, paid to speak and provided with financial assistance for educational purposes by many manufacturers of non-steroidal anti-inflammatory drugs, new and old. RS Taylor has undertaken paid presentations for Pfizer (Canada) and Novartis (UK) not related to rheumatoid arthritis or osteoarthritis management. HTA Published April 2008This report should be referenced as follows:Chen Y-F, Jobanputra P, Barton P, Bryan S, Fry-Smith A, Harris G, et al. Cyclooxygenase-2 selective non-steroidal anti-inflammatory drugs (etodolac, meloxicam, celecoxib, rofecoxib, etoricoxib, valdecoxib and lumiracoxib) NIHR Health Technology Assessment ProgrammeT he Health Technology Assessment (HTA) Programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in th...

Pain Management in the Cirrhotic Patient: The Clinical Challenge

“…Studies comparing nSAIds with COX-2 inhibitors in patients without underlying liver disease have demonstrated similar effectiveness in the treatment of musculoskeletal pain. 32,33 Although some COX-2 inhibitors may protect against gastrointestinal hemorrhage compared with nSAIds, an increased risk of cardiovascular adverse events has been observed. Cyclooxygenases are highly regulated in response to changes in intravascular volume, and COX-2 is implicated in the mediation of renin release, sodium regulation, and the maintenance of renal blood flow.…”

Cost Effectiveness of Duloxetine for Osteoarthritis: A Quebec Societal Perspective

“…However, treatment from the post-discontinuation therapy continued for life. Also, several other models, including those by Bessette et al (44), Chen et al (45), and Maetzel et al (21), have used similar maximum treatment lengths. The NICE model (20) utilized a base-case treatment duration of 3 months, but in sensitivity analysis allowed for lifetime treatment.…”

Untitled

“…NICE failed to update this guidance in 2004, when it was due, after rofecoxib was withdrawn; an independent review completed at that time has only recently been published. 3 The current guideline recommends that a traditional NSAID or a COX-2 inhibitor may be offered if a topical NSAID and/or paracetamol are ineffective, but that both standard NSAIDs and COX 2 inhibitors, at the lowest effective dose and for the shortest time necessar y, should be given with a proton pump inhibitor (PPI). A decision to recommend more liberal use of PPIs is surprising and justified by an economic analysis 4 that depends on a number of questionable assumptions and disregards possible differences in cardiovascular risk between different NSAIDs.…”