Efficacy and safety profile of treatment with etoricoxib 120 mg once daily compared with indomethacin 50 mg three times daily in acute gout: A randomized controlled trial

Abstract

Objective. To evaluate the efficacy and safety of etoricoxib and indomethacin in the treatment of patients with acute gout.Methods. A randomized, double-blind, activecomparator study was conducted at 42 sites. A total of 189 men and women (>18 years of age) who were experiencing an acute attack (<48 hours) of clinically diagnosed gout were treated for 8 days with etoricoxib, 120 mg/day (n ‫؍‬ 103), or indomethacin, 50 mg 3 times a day (n ‫؍‬ 86). The primary efficacy end point was the patient's assessment of pain in the study joint (0-4-point Likert scale) over days 2-5. Safety was assessed by adverse experiences (AEs) occurring during the trial.Results. Etoricoxib demonstrated clinical efficacy comparable to that of indomethacin in terms of the patient's assessment of pain in the study joint. The difference in the mean change from baseline over days 2-5 was -0.08 (95% confidence interval -0.29, 0.13) (P ‫؍‬ 0.46), which fell within the prespecified comparability bounds of -0.5 to 0.5. Secondary end points over the 8-day study, including the onset of efficacy, reduction in signs of inflammation, and patient's and investigator's global assessments of response to therapy, confirmed the comparable efficacy of the two treatments. The etoricoxib-treated patients had a numerically lower incidence of AEs (43.7%) than did the indomethacintreated patients (57.0%) and a significantly lower incidence of drug-related AEs (16.5% versus 37.2%; P < 0.05).Conclusion. Etoricoxib at a dosage of 120 mg once daily was confirmed to be an effective treatment for acute gout. Etoricoxib was comparable in efficacy to indomethacin at a dosage of 50 mg 3 times daily, and it was generally safe and well tolerated.Acute gouty arthritis is the most common form of inflammatory joint disease in men over the age of 40 years (1,2). It is estimated to affect 0.5-2.8% of men, with a lower rate of occurrence among women, who experience gout primarily after menopause (3). The prevalence is much higher among individuals with a positive family history (3). Monosodium urate monohydrate crystals, which arise from abnormal metabolism of purines, cause an intense inflammatory reaction that

Foot pain, impairment, and disability in patients with acute gout flares: A prospective observational study

“…The severity of foot pain at the time of the gout flare was consistent with reports of generalized pain from clinical trials of acute gout (25,26). We observed that at the followup visit, pain did not entirely resolve, suggesting that foot-related pain may be a constant feature in patients with recurrent gout flares.…”

Напроксен: Нова Стратегія Зниження Серцево-Судинного Ризику Нестероїдних Протизапальних Препаратів

“…По литературным данным, этодолак был изучен более широко и имел профиль риска, ана-логичный рофекоксибу. Индометацин имеет профиль сердечно-сосудистого риска, аналогичный диклофе-наку, но ассоциируется с высоким риском развития же-лудочно-кишечного повреждения, а также побочными эффектами со стороны центральной нервной системы [65,66]. Мелоксикам похож на ибупрофен и целекоксиб и, вероятно, имеет уровень риска серьезных желудоч-но-кишечных событий, подобный диклофенаку [67], однако, принимая во внимание его относительную ЦОГ-2-селективность, рекомендовано избегать его назначения пациентам с высоким риском развития сердечно-сосудистых событий.…”

“…Мелоксикам активно использует-ся в Австралии, где он частично заменил рофекоксиб, но данные по нему незначительны [12]. Индометацин до сих пор широко используется при лечении острой подагры [13]. Диклофенак был детально изучен при проведении анализа сердечно-сосудистого риска, его сравнивали с другими широко используемыми пре-паратами, в частности ибупрофеном и напроксеном, которые, как и диклофенак, доступны во многих странах без рецепта [14,15].…”

A Randomized, Controlled Trial to Assess the Efficacy of Arthroscopic Debridement in Combination with Oral Medication Versus Oral Medication in Patients with Gouty Knee Arthritis

“…In both groups, gout suppressants were orally administered (on postoperative day 2 in the surgery group): colchicine 0.5-1.5 mg for 14 days [9], followed by allopurinol (0.1 g, tid) for 3 months, and sodium bicarbonate tablet (0.9 g, tid) for 3 months [10]. A strict diet plan was also emphasized based on the avoidance of animal offal and bean products and high water intake [11].…”