Yoo Myung Chul, Yoo Wan Hee, Kang Seung Baek, Park Yong-Wook, Kim Sung Soo, Moon Kyoung Ho, Song Yeong Wook, Min Byung Woo, Cho Yoon Je, Moon Seong-Hwan, Bin Seong-Il, Baek Han-Joo, Shim Seung Cheol, Lee Sung Won, Yoo Dae Hyun, Mehta Anish, Skuban Aleksandar, Cukrow Diane M, Vandormael Kristel, Yan Li
Kyung Hee University Hospital , Seoul , Republic of Korea.
Curr Med Res Opin. 2014 Dec;30(12):2399-408. doi: 10.1185/03007995.2014.955169. Epub 2014 Sep 3.
We evaluated the COX-2 inhibitors, etoricoxib and celecoxib, in Korean patients with osteoarthritis (OA).
This study included patients (≥ 40 years of age) with a clinical and radiographic diagnosis of knee OA. Patients were randomized to etoricoxib 30 mg (qd) or celecoxib 200 mg (qd) in a 12 week randomized, controlled, double-blind study. Prior NSAID users were to demonstrate a worsening of symptoms upon withdrawal of medication. Efficacy endpoints included the time-weighted average change from baseline in the WOMAC VA 3.0 Pain Subscale (100 mm Visual Analog Scale [VAS]; primary endpoint), the WOMAC VA 3.0 Physical Function Subscale (100 mm VAS), and Patient Global Assessment of Disease Status (PGAD) (100 mm VAS). The primary hypothesis was that etoricoxib 30 mg is non-inferior to celecoxib 200 mg as assessed by the primary endpoint (the non-inferiority margin was set at 10 mm VAS). Adverse events (AEs), laboratory parameters, and vital signs were monitored.
There were 239 patients (89.5% female; mean age: 63.3 years) randomized to etoricoxib 30 mg (n = 120) and celecoxib 200 mg (n = 119). The differences (etoricoxib vs celecoxib) in least square (LS) mean change (95% CI) for WOMAC Pain, WOMAC Physical Function, and PGAD were -1.63 mm (-5.37, 2.10), -1.32 mm (-4.88, 2.23), and -1.09 mm (-5.48, 3.30), respectively. Drug-related clinical AEs occurred in 6.7% (etoricoxib) and 2.5% (celecoxib) of patients. This study was limited because it was not designed or powered to adequately capture and evaluate rare AEs associated with NSAID treatment.
Etoricoxib 30 mg administered once daily in Korean patients with knee OA demonstrated non-inferior clinical efficacy to celecoxib 200 mg over 12 weeks of treatment as assessed by all primary and secondary outcomes. Etoricoxib 30 mg qd and celecoxib 200 mg qd were generally safe and well tolerated.
NCT01554163.
我们评估了环氧化酶-2(COX-2)抑制剂依托考昔和塞来昔布在韩国骨关节炎(OA)患者中的疗效。
本研究纳入了临床及影像学诊断为膝关节OA的患者(年龄≥40岁)。在一项为期12周的随机、对照、双盲研究中,患者被随机分为服用30毫克依托考昔(每日一次)或200毫克塞来昔布(每日一次)。之前使用非甾体抗炎药(NSAID)的患者在停药后症状应有所加重。疗效终点包括WOMAC骨关节炎指数3.0疼痛子量表(100毫米视觉模拟量表[VAS];主要终点)、WOMAC骨关节炎指数3.0身体功能子量表(100毫米VAS)以及患者疾病状况总体评估(PGAD)(100毫米VAS)自基线的时间加权平均变化。主要假设是,通过主要终点评估(非劣效性界值设定为10毫米VAS),30毫克依托考昔不劣于200毫克塞来昔布。对不良事件(AE)、实验室指标和生命体征进行了监测。
共有239例患者(89.5%为女性;平均年龄:63.3岁)被随机分为服用30毫克依托考昔组(n = 120)和服用200毫克塞来昔布组(n = 119)。WOMAC疼痛、WOMAC身体功能和PGAD的最小二乘(LS)均值变化(95%CI)差异(依托考昔组对比塞来昔布组)分别为-1.63毫米(-5.37,2.10)、-1.32毫米(-4.88,2.23)和-1.09毫米(-5.48,3.30)。与药物相关的临床不良事件分别发生在6.7%的依托考昔组患者和2.5%的塞来昔布组患者中。本研究存在局限性,因为其设计和效能不足以充分捕捉和评估与NSAID治疗相关的罕见不良事件。
在韩国膝关节OA患者中,每日一次服用30毫克依托考昔,在12周的治疗期内,根据所有主要和次要结局评估,其临床疗效不劣于200毫克塞来昔布。每日一次服用30毫克依托考昔和每日一次服用200毫克塞来昔布总体上安全且耐受性良好。
NCT01554163