Etoricoxib

Abstract

Etoricoxib is a cyclo-oxygenase (COX)-2-selective NSAID with a higher COX-1 to COX-2 selectivity ratio than the other COX-2-selective NSAIDs rofecoxib, valdecoxib or celecoxib. In patients with rheumatoid arthritis, improvements in tender and swollen joint counts and patient and investigator global assessment of disease activity were significantly greater in etoricoxib than in placebo recipients in two studies. Etoricoxib was also significantly more effective than naproxen in one of these studies. In patients with osteoarthritis of the hip or knee, etoricoxib was significantly more effective than placebo and had similar efficacy to naproxen with regards to improvements in pain and physical function scores and patient global assessment of disease status scores in two studies. Etoricoxib had similar efficacy to diclofenac in patients with osteoarthritis of the knee. Single-dose etoricoxib relieved pain in patients with postoperative dental pain in two studies. Similar scores assessing total pain relief over 8 hours (TOPAR8) were reported in etoricoxib and naproxen sodium or ibuprofen recipients, and higher TOPAR8 scores were reported with etoricoxib than with paracetamol (acetaminophen)/codeine. Pain relief was significantly better with etoricoxib than placebo in two studies in patients with chronic low back pain. Etoricoxib had similar efficacy to indomethacin in a study in patients with acute gout, and single-dose etoricoxib had similar efficacy to naproxen sodium in a study in women with primary dysmenorrhoea. Compared with non-COX-selective NSAIDs, etoricoxib was associated with significantly fewer upper gastrointestinal (GI) perforations, ulcers or bleeds, and was significantly less likely to result in treatment discontinuation because of NSAID-type GI symptoms or any GI symptoms.

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

“…Changes in serum creatinine levels were small and were similar between the 2 treatment groups. Similarities between NSAIDs and COX-2 inhibitors, including etoricoxib, in terms of their effects on renal function have previously been reported, suggesting that COX-2 inhibitors do not offer a clinically relevant advantage over nonselective inhibitors with regard to renal AEs (39,40).…”

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

“…NSAIDs are considered to be the most potent NSAID for the treatment of gout [1]. Etoricoxib, a novel 6 Forest plot of mean difference in gastrointestinal tract side effects and dizziness and 95 % CI cyclooxygenase 2 (COX-2) inhibitor, has anti-inflammatory, analgesic, and antipyretic activities in models of acute or chronic pain and inflammation in osteoarthritis, ankylosing spondylitis, and rheumatoid arthritis [24][25][26][27]. To our knowledge, this is the first quantitative comparative meta-analysis of studies directly comparing etoricoxib and NSAIDs for the treatment of acute gout.…”

Effects of preemptive analgesia in laparoscopic cholecystectomy: a double-blind randomized controlled trial

“…The hypothesis was that patients receiving etoricoxib would experience less pain and request less supplemental opioid analgesic than patients receiving placebo. Etoricoxib is a cyclooxygenase (COX)-2-selective NSAID with a higher COX-1-to-COX-2 selectivity ratio than the other COX-2-selective NSAIDs such as rofecoxib, valdecoxib, or celecoxib [16]. With etoricoxib, once-daily dosing is appropriate based on its long half-life of 22 h. Rapid symptomatic responses are observed related to the short time to peak plasma concentration of about 1 h [17].…”