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一项比较30毫克依托考昔与2400毫克布洛芬治疗骨关节炎患者疗效的随机安慰剂对照试验。

A randomized placebo-controlled trial comparing the efficacy of etoricoxib 30 mg and ibuprofen 2400 mg for the treatment of patients with osteoarthritis.

作者信息

Puopolo A, Boice J A, Fidelholtz J L, Littlejohn T W, Miranda P, Berrocal A, Ko A, Cichanowitz N, Reicin A S

机构信息

Milford Emergency Associates, Milford, MA, USA.

出版信息

Osteoarthritis Cartilage. 2007 Dec;15(12):1348-56. doi: 10.1016/j.joca.2007.05.022. Epub 2007 Jul 16.

Abstract

OBJECTIVE

We compared the efficacy of etoricoxib 30 mg to placebo and ibuprofen 2400 mg for the treatment of osteoarthritis (OA) of the hip and knee.

DESIGN

In this 12-week, randomized, double-blind, placebo- and active-comparator-controlled trial, 548 patients (median age 63 years) with OA of the hip or knee were randomized to receive placebo, etoricoxib 30 mg q.d., or ibuprofen 800 mg t.i.d. Demonstration of etoricoxib's efficacy vs placebo and comparison of its efficacy to ibuprofen were assessed using three co-primary endpoints: Western Ontario and McMaster's University Osteoarthritis Index (WOMAC) Pain Subscale (WOMAC-PS); WOMAC Physical Function Subscale (WOMAC-PFS); and Patient Global Assessment of Disease Status (PGADS). Each primary endpoint utilizes a 0-100 mm visual analog scale. To demonstrate comparable efficacy of etoricoxib vs ibuprofen, the 95% confidence intervals (CIs) for the difference in the least squares (LS) mean change over 12 weeks for all three co-primary endpoints had to fall within +/-10 mm. Safety and tolerability data were collected throughout the study.

RESULTS

Mean baseline values for the three co-primary endpoints ranged from 62.52 to 70.14 mm. Both etoricoxib and ibuprofen demonstrated superior (P< or =0.002) efficacy for all primary endpoints. The LS mean (mm) changes (95% CI) over 12 weeks for etoricoxib and ibuprofen, respectively, compared to placebo were given as follows: WOMAC-PS: -11.66 (-16.31, -7.01) and -7.62 (-12.30, -2.94); WOMAC-PFS: -10.15 (-14.74, -5.57) and -7.23 (-11.85, -2.61); PGADS: -11.65 (-16.81, -6.50) and -8.11 (-13.30, -2.92). The efficacy of etoricoxib 30 mg was comparable to ibuprofen 2400 mg. All treatments were similarly well tolerated.

CONCLUSION

Treatment with etoricoxib 30 mg q.d. provides superior efficacy vs placebo and comparable clinical efficacy vs ibuprofen 2400 mg (800 mg t.i.d.) for the treatment of OA of the hip and knee.

摘要

目的

我们比较了30毫克依托考昔与安慰剂及2400毫克布洛芬治疗髋和膝骨关节炎(OA)的疗效。

设计

在这项为期12周的随机、双盲、安慰剂和活性对照药对照试验中,548例髋或膝OA患者(中位年龄63岁)被随机分为接受安慰剂、每日一次30毫克依托考昔或每日三次800毫克布洛芬治疗。依托考昔与安慰剂疗效的论证及其与布洛芬疗效的比较通过三个共同主要终点进行评估:西安大略和麦克马斯特大学骨关节炎指数(WOMAC)疼痛分量表(WOMAC-PS);WOMAC身体功能分量表(WOMAC-PFS);以及患者对疾病状态的整体评估(PGADS)。每个主要终点均采用0至100毫米视觉模拟量表。为论证依托考昔与布洛芬疗效相当,所有三个共同主要终点在12周内最小二乘(LS)均值变化差异的95%置信区间(CIs)必须落在±10毫米范围内。在整个研究过程中收集安全性和耐受性数据。

结果

三个共同主要终点的平均基线值范围为62.52至70.14毫米。依托考昔和布洛芬在所有主要终点均显示出更优疗效(P≤0.002)。与安慰剂相比,依托考昔和布洛芬在12周内的LS均值(毫米)变化(95%CI)如下:WOMAC-PS:-11.66(-16.31,-7.01)和-7.62(-12.30,-2.94);WOMAC-PFS:-10.15(-14.74,-5.57)和-7.23(-11.85,-2.61);PGADS:-11.65(-16.81,-6.50)和-8.11(-13.30,-2.92)。30毫克依托考昔的疗效与2400毫克布洛芬相当。所有治疗的耐受性相似。

结论

每日一次服用30毫克依托考昔治疗髋和膝OA,与安慰剂相比疗效更优,与2400毫克(每日三次800毫克)布洛芬相比临床疗效相当。

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