Etoricoxib Provides Analgesic Efficacy to Patients After Knee or Hip Replacement Surgery: A Randomized, Double-Blind, Placebo-Controlled Study

Rasmussen, G. Lynn; Malmström, Kerstin; Bourne, Michael H.; Jové, Maurice; Rhondeau, Steven; Kotey, Paul; Ang, Jennifer; Aversano, Michelle; Reicin, Alise

doi:10.1213/01.ane.0000169294.41210.9e

Cited by 40 publications

(32 citation statements)

References 23 publications

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“…[12][13][14][15][16] In a dose-ranging study using the postoperative dental pain model, 120 mg was found to be the minimal dose with maximal efficacy of the doses studied, including 60, 180, and 240 mg; etoricoxib 120 mg was superior to 60 mg whereas the 180 and 240 mg doses provided no additional efficacy. 14 The same study has also shown that etoricoxib 120 mg was superior to ibuprofen 400 mg in a single dose comparison according to the primary endpoint, total pain relief over 8 hours, although it should be noted that the maximal daily dose of ibuprofen is 2400 mg taken as 600 mg 4 times a day, which is the regimen included as an active comparator in this study.…”

Section: Discussionmentioning

confidence: 94%

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Evaluation of the Dose Range of Etoricoxib in an Acute Pain Setting Using the Postoperative Dental Pain Model

Daniels

Bandy

Christensen

et al. 2011

The Clinical Journal of Pain

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Section: Discussionmentioning

confidence: 94%

“…Earlier studies have shown the clinically important efficacy with etoricoxib (120 mg). 6,[12][13][14][15] This study was conducted to evaluate additional doses of etoricoxib (90 and 120 mg) in this acute pain setting.…”

mentioning

confidence: 99%

Evaluation of the Dose Range of Etoricoxib in an Acute Pain Setting Using the Postoperative Dental Pain Model

Daniels

Bandy

Christensen

et al. 2011

The Clinical Journal of Pain

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“…Thus, Rasmussen et al showed that etoricoxib 120 mg after surgery in patients with TKA or THA provided analgesia superior to placebo and similar to naproxen 1100 mg [16]. The results of a study of Rawal et al showed that etoricoxib 120 mg was administered also postoperatively in patients with TKA effects superior to placebo and equal to ibuprofen 1800 mg to reduce pain at rest and opioid consumption [17].…”

Section: Discussionmentioning

confidence: 99%

Postoperative Etoricoxib versus Ketoprofen Administration for Pain Management after Total Knee Arthroplasty: A Randomized, Double-Blind Controlled Study

Florescu

Anastase

Munteanu

et al. 2015

Journal of Anesthesiology

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Objective. This randomized double-blind study compared the analgesic efficacy and tolerability of etoricoxib versus ketoprofen in 165 patients with elective total primary knee arthroplasty. Methods. After ethical committee approval, 165 patients were randomized in 3 groups: the etoricoxib group (E) receiving etoricoxib 120 mg/day, at the end of surgery and in the first postoperative day; the ketoprofen group (K) receiving ketoprofen 2 pills of 100 mg/day, the first at the end of surgery and then 1 pill every 12 hours in the surgery day and the first postoperative day; the placebo group (P). All groups received postoperatively the same analgesia protocol when NRS is over 3 with IV Perfalgan and morphine. The effectiveness was evaluated by the time from the initiation of spinal anesthesia until the first analgesic dose, the total amount of morphine administered in the surgery day and the first postoperative day, and the frequency of patients with side effects and necessary amount of adjuvant medication. Results. The baseline demographic characteristics were similar among the 3 groups. In both study days etoricoxib provided an analgesic effect superior to placebo and to ketoprofen, the total administered morphine being significantly lower in etoricoxib group. There were no statistically significant differences between groups regarding the side effects.

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“…Etoricoxib has demonstrated efficacy in many painful conditions, including a previous study that demonstrated efficacy in patients undergoing total knee or hip arthroplasty [11]. Its pharmacokinetic profile shows a lack of effect on COX-1, and, therefore, it has minimal effects on platelet aggregation [12] making it an appropriate treatment in surgical settings in contrast to traditional NSAIDs such as ibuprofen.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of etoricoxib in patients undergoing total knee replacement surgery in a double-blind, randomized controlled trial

Rawal

Viscusi

Peloso

et al. 2013

BMC Musculoskelet Disord

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BackgroundOptimal postoperative pain management is important to ensure patient comfort and early mobilization.MethodsIn this double-blind, placebo- and active-controlled, randomized clinical trial, we evaluated postoperative pain following knee replacement in patients receiving placebo, etoricoxib (90 or 120 mg), or ibuprofen 1800 mg daily for 7 days. Patients ≥18 years of age who had pain at rest ≥5 (0–10 Numerical Rating Scale [NRS]) after unilateral total knee replacement were randomly assigned to placebo (N = 98), etoricoxib 90 mg (N = 224), etoricoxib 120 mg (N = 230), or ibuprofen 1800 mg (N = 224) postoperatively. Co-primary endpoints included Average Pain Intensity Difference at Rest over Days 1–3 (0- to 10-point NRS) and Average Total Daily Dose of Morphine over Days 1–3. Pain upon movement was evaluated using Average Pain Intensity Difference upon Knee Flexion (0- to 10-point NRS). The primary objective was to demonstrate analgesic superiority for the etoricoxib doses vs. placebo; the secondary objective was to demonstrate that the analgesic effect of the etoricoxib doses was non-inferior to ibuprofen. Adverse experiences (AEs) including opioid-related AEs were evaluated.ResultsThe least squares (LS) mean (95% CI) differences from placebo for Pain Intensity Difference at Rest over Days 1–3 were -0.54 (-0.95, -0.14); -0.49 (-0.89, -0.08); and -0.45 (-0.85, -0.04) for etoricoxib 90 mg, etoricoxib 120 mg, and ibuprofen, respectively (p < 0.05 for etoricoxib vs. placebo). Differences in LS Geometric Mean Ratio morphine use over Days 1–3 from placebo were 0.66 (0.54, 0.82); 0.69 (0.56, 0.85); and 0.66 (0.53, 0.81) for etoricoxib 90 mg, etoricoxib 120 mg, and ibuprofen, respectively (p < 0.001 for etoricoxib vs. placebo). Differences in LS Mean Pain Intensity upon Knee Flexion were -0.37 (-0.85, 0.11); -0.46 (-0.94, 0.01); and -0.42 (-0.90, 0.06) for etoricoxib 90 mg, etoricoxib 120 mg, and ibuprofen, respectively. Opioid-related AEs occurred in 41.8%, 34.7%, 36.5%, and 36.3% of patients on placebo, etoricoxib 90 mg, etoricoxib 120 mg, and ibuprofen, respectively.ConclusionsPostoperative use of etoricoxib 90 and 120 mg in patients undergoing total knee replacement is both superior to placebo and non-inferior to ibuprofen in reducing pain at rest and also reduces opioid (morphine) consumption.Clinical trial registrationNCT00820027

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Etoricoxib Provides Analgesic Efficacy to Patients After Knee or Hip Replacement Surgery: A Randomized, Double-Blind, Placebo-Controlled Study

Cited by 40 publications

References 23 publications

Evaluation of the Dose Range of Etoricoxib in an Acute Pain Setting Using the Postoperative Dental Pain Model

Evaluation of the Dose Range of Etoricoxib in an Acute Pain Setting Using the Postoperative Dental Pain Model

Postoperative Etoricoxib versus Ketoprofen Administration for Pain Management after Total Knee Arthroplasty: A Randomized, Double-Blind Controlled Study

Evaluation of etoricoxib in patients undergoing total knee replacement surgery in a double-blind, randomized controlled trial

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