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依托考昔

Etoricoxib.

作者信息

Cochrane Deborah J, Jarvis Blair, Keating Gillian M

机构信息

Adis International Limited, Mairangi Bay, Auckland, New Zealand.

出版信息

Drugs. 2002;62(18):2637-51; discussion 2652-3. doi: 10.2165/00003495-200262180-00006.

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.

摘要

依托考昔是一种环氧化酶(COX)-2选择性非甾体抗炎药,与其他COX-2选择性非甾体抗炎药罗非昔布、伐地昔布或塞来昔布相比,其COX-1与COX-2的选择性比率更高。在两项研究中,对于类风湿性关节炎患者,依托考昔组压痛和肿胀关节数的改善以及患者和研究者对疾病活动的整体评估,均显著优于安慰剂组。在其中一项研究中,依托考昔的疗效也显著优于萘普生。在两项研究中,对于髋或膝骨关节炎患者,依托考昔在改善疼痛和身体功能评分以及患者对疾病状态评分的整体评估方面,显著优于安慰剂,且与萘普生疗效相似。对于膝骨关节炎患者,依托考昔与双氯芬酸疗效相似。在两项研究中,单剂量依托考昔可缓解术后牙痛患者的疼痛。依托考昔组与萘普生钠或布洛芬组报告的8小时总疼痛缓解评估(TOPAR8)评分相似,且依托考昔组的TOPAR8评分高于对乙酰氨基酚/可待因组。在两项慢性下腰痛患者的研究中,依托考昔的止痛效果显著优于安慰剂。在一项急性痛风患者的研究中,依托考昔与吲哚美辛疗效相似,在一项原发性痛经女性患者的研究中,单剂量依托考昔与萘普生钠疗效相似。与非COX选择性非甾体抗炎药相比,依托考昔导致上消化道(GI)穿孔、溃疡或出血的情况显著较少,且因非甾体抗炎药类GI症状或任何GI症状导致治疗中断的可能性显著较低。

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