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COX-2特异性抑制剂伐地考昔治疗髋关节骨关节炎的疗效与安全性:一项与萘普生对比的随机、双盲、安慰剂对照研究

Efficacy and safety of the COX-2 specific inhibitor valdecoxib in the management of osteoarthritis of the hip: a randomized, double-blind, placebo-controlled comparison with naproxen.

作者信息

Makarowski W, Zhao William W, Bevirt Terry, Recker David P

机构信息

Rheumatology Associates of NW Pennsylvania, Erie, Pennsylvania, USA.

出版信息

Osteoarthritis Cartilage. 2002 Apr;10(4):290-6. doi: 10.1053/joca.2001.0510.

Abstract

OBJECTIVE

Non-steroidal antiinflammatory agents are commonly used to treat pain and inflammation associated with osteoarthritis (OA), but have poor gastrointestinal (GI) tolerability. This study compared the efficacy of the COX-2 specific inhibitor valdecoxib with naproxen and placebo, in treating symptomatic OA of the hip.

DESIGN

This multicenter, randomized, double-blind 12-week study compared the efficacy and tolerability of single daily doses of valdecoxib 5 mg and 10 mg with placebo or naproxen 500 mg BID. Efficacy was assessed by Patient's and Physician's Global Assessment of Arthritis, and the WOMAC (Western Ontario and McMasters) OA Individual and Composite Indices. The incidence of adverse events was monitored throughout the study.

RESULTS

Valdecoxib was clinically and statistically superior to placebo for Patient's and Physician's Global Assessment of Arthritis and for all WOMAC OA Indices over the 12 week study period (P<or= 0.05). Valdecoxib 10 mg was similar to naproxen in terms of efficacy, and demonstrated greater numerical improvements compared with valdecoxib 5 mg. Valdecoxib 5 mg and 10 mg demonstrated similar tolerability compared to placebo and a lower incidence of GI-related adverse effects compared with naproxen.

CONCLUSIONS

Single daily doses of valdecoxib 5 mg and 10 mg were similar to naproxen and superior to placebo, in treating symptomatic OA of the hip. Both doses of valdecoxib were well tolerated and demonstrated improved GI tolerability compared to naproxen.

摘要

目的

非甾体抗炎药常用于治疗与骨关节炎(OA)相关的疼痛和炎症,但胃肠道(GI)耐受性较差。本研究比较了COX-2特异性抑制剂伐地昔布与萘普生和安慰剂治疗髋部症状性OA的疗效。

设计

这项多中心、随机、双盲的12周研究比较了每日单剂量5毫克和10毫克伐地昔布与安慰剂或500毫克萘普生每日两次的疗效和耐受性。通过患者和医生对关节炎的整体评估以及WOMAC(西安大略和麦克马斯特)OA个体和综合指数评估疗效。在整个研究过程中监测不良事件的发生率。

结果

在12周的研究期内,伐地昔布在患者和医生对关节炎的整体评估以及所有WOMAC OA指数方面在临床和统计学上均优于安慰剂(P≤0.05)。伐地昔布10毫克在疗效方面与萘普生相似,与5毫克伐地昔布相比有更大的数值改善。与安慰剂相比,5毫克和10毫克伐地昔布的耐受性相似,与萘普生相比,胃肠道相关不良反应的发生率更低。

结论

每日单剂量5毫克和10毫克伐地昔布在治疗髋部症状性OA方面与萘普生相似且优于安慰剂。两种剂量的伐地昔布耐受性良好,与萘普生相比,胃肠道耐受性有所改善。

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