Efficacy and Tolerability of Celecoxib in the Treatment of Acute Gouty Arthritis: A Randomized Controlled Trial

Schumacher, H. Ralph; Berger, Manuela; Li-Yu, Julie; Pérez-Ruiz, Fernando; Burgos‐Vargas, Rubén; Li, Chunming

doi:10.3899/jrheum.110916

Cited by 51 publications

(33 citation statements)

References 24 publications

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“…Sensitivity to change for the 5-point Likert scale has been demonstrated with effect sizes of 2.17-2.47 following two days of NSAID treatment (17). Between-group discrimination has been demonstrated in two separate clinical trials (18, 19). …”

Section: Resultsmentioning

confidence: 97%

“…Thus, assessment of between-group discrimination for the purposes of the OMERACT filter is somewhat limited. However, several studies did allow analysis of between-group discrimination, particularly a placebo-controlled study of colchicine published in 1987 (15), a randomised controlled trial comparing high-dose and low-dose celecoxib (19), several RCTs comparing canakinumab with triamcinolone (13, 18), and a study comparing a Chinese herbal medication with indomethacin (28). Although the minimal important difference has not been reported for instruments assessing acute gout, statistical differences could be detected both within- and between-groups, for the following measures: pain VAS, 5-point pain Likert score, 4-point physician assessments of index joint swelling and tenderness, TJC, SJC and PGART.…”

Section: Discussionmentioning

confidence: 99%

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Outcome Measures in Acute Gout: A Systematic Literature Review

Dalbeth

Zhong²,

Grainger³

et al. 2013

J Rheumatol

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Objective Five core domains have been endorsed by Outcomes Measures in Rheumatology (OMERACT) for acute gout: pain, joint swelling, joint tenderness, patient global assessment, and activity limitation. The aim of this work was to evaluate instruments for these domains according to the OMERACT filter: truth, feasibility, and discrimination. Methods A systematic search strategy for instruments used to measure the acute gout core domains was formulated. For each method, articles were assessed by two reviewers to summarise information according to the specific components of the OMERACT filter. Results Seventy-seven articles and abstracts met the inclusion criteria. Pain was most frequently reported (76 studies, 20 instruments). The pain instruments used most often were 100mm visual analog scale (VAS) and 5-point Likert scale. Both methods have high feasibility, face and content validity, within- and between-group discrimination. Four-point Likert scales assessing index joint swelling and tenderness have been used in numerous acute gout studies; these instruments are feasible, with high face and content validity, and show within- and between-group discrimination. Five-point patient global assessment of response to treatment (PGART) scales are feasible and valid, and show within- and between-group discrimination. Measures of activity limitations were infrequently reported, and insufficient data were available to make definite assessments of the instruments for this domain. Conclusion Many different instruments have been used to assess the acute gout core domains. Pain VAS and 5-point Likert scales, 4-point Likert scales of index joint swelling and tenderness and 5-point PGART instruments meet the criteria for the OMERACT filter.

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Section: Resultsmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Outcome Measures in Acute Gout: A Systematic Literature Review

Dalbeth

Zhong²,

Grainger³

et al. 2013

J Rheumatol

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“…Cyclooxygenase 2 (COX-2) inhibitors are an option for patients with gastrointestinal contraindications or intolerance to NSAIDs. Several randomized controlled trials (RCTs) have been published that support the efficacy of COX-2 inhibitors like etoricoxib, lumiracoxib, and celecoxib [9][10][11]. However, there is still not much evidence to indicate efficacy of these treatments.…”

Section: Introductionmentioning

confidence: 96%

Efficacy and safety of etoricoxib compared with NSAIDs in acute gout: a systematic review and a meta-analysis

Zhang

Liu

et al. 2015

Clin Rheumatol

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The aim is to study the efficacy and safety of etoricoxib in the treatment of acute gout, as compared with non-steroidal anti-inflammatory drugs (NSAIDs). We conducted a computerized search of electronic databases: PubMed, EMBASE, Web of Science, China Biology Medicine disc, and Cochrane Library. The search terms were as follows: gout arthritis, tophus, etoricoxib, indometacin naproxen, diclofenac, and NSAIDs. Articles were searched from 1983 until August 2014. A manual search of peer-reviewed English documents was performed by cross-checking the bibliographies of selected studies. These trials reported pain relief as the primary outcome. Tenderness, swelling, patients' global assessments of response to treatment, and investigators' global assessments of response to treatment were reported as the secondary outcomes. All adverse events were recorded for safety assessment. Six trials including 851 patients were identified. Both etoricoxib and NSAIDs had an effect on inflammation and analgesia. Compared with indometacin and diclofenac, etoricoxib had a lower incidence of adverse events. Etoricoxib 120 mg administered orally once daily has the same efficacy on acute gout as indometacin and diclofenac. Etoricoxib is tolerated better by patients than NSAIDs such as indometacin and diclofenac.

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“…44, 45 Meðferð með naproxen er jafn góð og prednisólónkúr. 42 Einnig þarf að muna eftir frábendingum NSAID-lyfja, svo sem aldri og fleiru, sjá kafla um áhaettuhópa síðar í greininni.…”

Section: Nsaid þAr Með Talið Cox-2 Hemlarunclassified

Þvagsýrugigt - læknanleg liðbólga

Johannsdottir¹,

Palsson²,

Jónsson

et al. 2018

LBL

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INNGANGURÍ þessari grein höfum við leitast við að taka saman nýjustu upplýs-ingar og rannsóknir um þvagsýrugigt og vonumst til að efnið nýt-ist vel í klínískri vinnu laekna á Íslandi. Gerður er greinarmunur á haekkun þvagsýru í blóði og þvagsýrugigt þótt óneitanlega séu þessir þaettir nátengdir.Þvagsýrugigt er algengasti sjúkdómurinn sem veldur liðbólg-um og hefur möguleika á laekningu. Án meðferðar getur þvag-sýrugigt valdið bráðum og langvinnum liðbólgum, eyðileggingu á liðum og langvinnum verkjavanda. Margir sjúkdómar geta tengst þvagsýrugigt og ástandið getur valdið mikilli skerðingu á lífsgaeðum.1 Faraldsfraeðilegar rannsóknir benda til þess að þvag-sýrugigt sé vanmeðhöndluð og því hefur verið kallað eftir skýrum leiðbeiningum um viðeigandi greiningaraðferðir og meðferð. 2Þvagsýrugigt er allt að fjórfalt algengari meðal karla en kvenna og fer algengi sjúkdómsins vaxandi á heimsvísu.3,4 Á Vesturlönd-um er algengi frá 0,9-2,5% í Evrópu og 4% í Bandaríkjunum, og yfir 7% hjá sjúklingum yfir 65 ára. 5,6 Nýjar rannsóknir hafa komið fram á síðustu árum um tengsl haekkaðrar þvagsýru og þvagsýrugigtar við efnaskiptavillu, hjarta-og aeðasjúkdóma og aukna dánartíðni.2 Því hefur þótt rík ástaeða til að endurskoða evrópskar og bandarískar leiðbeiningar um forvarnir og meðferð þessara þátta. MEINMYNDUN Haekkun á þvagsýru og þvagsýrugigtÞvagsýrugigt er afleiðing haekkaðrar þvagsýru í blóði sem getur leitt til mónósódíum úrat (MSÚ) kristallaútfellinga, innan og/eða utan liða. Alþjóðleg viðmiðunargildi þvagsýruhaekkunar í blóði eru >400µmol/L fyrir karla en >350µmol/L fyrir konur.7,8 Á ÍslandiÞvagsýrugigt er liðbólgusjúkdómur sem í flestum tilfellum er laeknanlegur en algengi hans á heimsvísu fer vaxandi. Án meðferðar getur sjúkdómur-inn valdið varanlegum liðskemmdum en þrátt fyrir það benda rannsóknir til að vanmeðhöndlun sjúkdómsins sé mikil. Tengsl við lífsstílssjúkdóma á borð við efnaskiptavillu eru ótvíraeð en sjúkdómurinn getur einnig verið fylgikvilli lífshaettulegra sjúkdóma og meðferðar við þeim. Nú liggja fyrir nýlegar leiðbeiningar frá Bandaríkjunum og Evrópu varðandi greiningu og meðferð þvagsýrugigtar, baeði við bráðum liðbólgum sem og langtíma-meðferð. Aukin áhersla er lögð á meðferð til að fyrirbyggja sjúkdóminn, baeði með lífsstílsbreytingum og lyfjameðferð. Mikil áhersla er lögð á að fraeða sjúklinga um sjúkdóminn og tilvist góðra meðferðarúrraeða, hvernig skal bregðast við bráðri liðbólgu og mikilvaegi þess að laekka styrk þvag-sýru í blóði. Þegar sjúklingur greinist með þvagsýrugigt aetti að skima fyrir fylgisjúkdómum. Það er mikilvaegt að setja meðferðarmarkmið þvag-sýrulaekkunar og fylgja þeim með eftirfylgd yfir langan tíma, því þannig er haegt að koma þvagsýrugigt í varanlegt sjúkdómshlé. Þvagsýrugigt -laeknanleg liðbólgaGuðrún Arna Jóhannsdóttir *1 laeknir, Ólafur Pálsson *1 laeknir, Helgi Jónsson 2,4 laeknir, Björn Guðbjörnsson 3,4 laeknir eru viðmiðunargildin fyrir karla >480µmol/L og fyrir konur >50 ára eru þau >400µmol/L (samkvaemt handbók klínískrar lífefna-fraeðideildar á Landspítala) sem ef ti...

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Efficacy and Tolerability of Celecoxib in the Treatment of Acute Gouty Arthritis: A Randomized Controlled Trial

Abstract: High-dose celecoxib (800/400 mg) was significantly more effective than low-dose celecoxib (50 mg bid) and comparable to indomethacin in the treatment of moderate to extreme pain in patients with acute gouty arthritis. Further, celecoxib was well tolerated.

Cited by 51 publications

References 24 publications

Outcome Measures in Acute Gout: A Systematic Literature Review

Outcome Measures in Acute Gout: A Systematic Literature Review

Efficacy and safety of etoricoxib compared with NSAIDs in acute gout: a systematic review and a meta-analysis

Þvagsýrugigt - læknanleg liðbólga

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