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在两项设计相同的随机、安慰剂对照、非劣效性研究中,依托考昔30毫克和塞来昔布200毫克治疗骨关节炎的疗效和安全性。

Efficacy and safety of etoricoxib 30 mg and celecoxib 200 mg in the treatment of osteoarthritis in two identically designed, randomized, placebo-controlled, non-inferiority studies.

作者信息

Bingham C O, Sebba A I, Rubin B R, Ruoff G E, Kremer J, Bird S, Smugar S S, Fitzgerald B J, O'Brien K, Tershakovec A M

机构信息

Johns Hopkins University Baltimore, MD, USA.

出版信息

Rheumatology (Oxford). 2007 Mar;46(3):496-507. doi: 10.1093/rheumatology/kel296. Epub 2006 Aug 27.

Abstract

OBJECTIVE

To compare the efficacy of etoricoxib 30 mg with the generally maximum recommended dose of celecoxib, 200 mg, in the treatment of osteoarthritis (OA) in two identically designed studies.

METHODS

Two multi-centre, 26-week, double-blind, placebo-controlled, non-inferiority studies were conducted, enrolling patients who were prior non-steroidal anti-inflammatory drug (NSAID) or acetaminophen users. There were 599 patients in study 1 and 608 patients in study 2 randomized 4:4:1:1 to etoricoxib 30 mg qd, celecoxib 200 mg qd or one of two placebo groups for 12 weeks. After 12 weeks, placebo patients were evenly distributed to etoricoxib or celecoxib based on their initial enrollment randomization schedule. The primary hypothesis was that etoricoxib 30 mg would be at least as effective as celecoxib 200 mg for the time-weighted average change from baseline over 12 weeks for Western Ontario and McMaster (WOMAC) Pain Subscale, WOMAC Physical Function Subscale and Patient Global Assessment of Disease Status. Active treatments were also assessed over the full 26 weeks. Adverse experiences were collected for safety assessment.

RESULTS

In both studies, etoricoxib was non-inferior to celecoxib for all three efficacy outcomes over 12 and 26 weeks; both were superior to placebo (P < 0.001) for all three outcomes in each study over 12 weeks. The safety and tolerability of etoricoxib 30 mg qd and celecoxib 200 mg qd were similar over 12 and 26 weeks.

CONCLUSIONS

Etoricoxib 30 mg qd was at least as effective as celecoxib 200 mg qd and had similar safety in the treatment of knee and hip OA; both were superior to placebo. ClinicalTrials.gov Identifiers: NCT00092768; NCT00092791.

摘要

目的

在两项设计相同的研究中,比较30毫克依托考昔与塞来昔布一般最大推荐剂量200毫克治疗骨关节炎(OA)的疗效。

方法

进行了两项多中心、为期26周、双盲、安慰剂对照、非劣效性研究,纳入既往使用过非甾体抗炎药(NSAID)或对乙酰氨基酚的患者。研究1有599例患者,研究2有608例患者,按4:4:1:1随机分为依托考昔30毫克每日一次、塞来昔布200毫克每日一次或两个安慰剂组之一,治疗12周。12周后,安慰剂组患者根据其初始入组随机化方案平均分配至依托考昔或塞来昔布组。主要假设是,在12周内,就西安大略和麦克马斯特大学(WOMAC)疼痛子量表、WOMAC身体功能子量表和患者疾病状况总体评估而言,依托考昔30毫克的疗效至少与塞来昔布200毫克相当,即从基线开始的时间加权平均变化。还在整个26周内对活性治疗进行了评估。收集不良事件以进行安全性评估。

结果

在两项研究中,依托考昔在12周和26周的所有三项疗效指标上均不劣于塞来昔布;在每项研究的12周内,两者在所有三项指标上均优于安慰剂(P<0.001)。在12周和26周内,依托考昔30毫克每日一次和塞来昔布200毫克每日一次的安全性和耐受性相似。

结论

依托考昔30毫克每日一次在治疗膝关节和髋关节OA方面至少与塞来昔布200毫克每日一次疗效相当,且安全性相似;两者均优于安慰剂。ClinicalTrials.gov标识符:NCT00092768;NCT00092791。

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