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To ascertain if etoricoxib increases the risk of gastrointestinal adverse events GAEs compared with placebo, diclofenac, and naproxen in the treatment of patients with osteoarthritis OA or rheumatoid arthritis RA. A meta-analysis was conducted using a fixed-effect model. Etoricoxib did not increase the risk of GAEs compared with placebo. Competing interests: The authors have declared that no competing interests exist. Osteoarthritis OA and rheumatoid arthritis RA are common diseases worldwide, as well as leading causes of morbidity and disability that threaten human health.
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Etoricoxib is a non-steroidal anti-inflammatory drug NSAIDs that is used as anti-inflammatory painkillers. It relieves pain and inflammation inflammation in conditions such as osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis, and it can also be used to treat gout for a limited time. The drug acts by inhibiting the cyclo-oxygenase-2 COX-2 enzyme, which is a natural chemical. This enzyme assists in the development of other chemicals in the body known as prostaglandins. Since COX-2 enzymes are inhibited, fewer prostaglandins are released, reducing pain and inflammation. Etoricoxib is used to minimise inflammation swelling and alleviate pain in arthritic disorders including osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. It's also used for short-term pain relief during gout attacks and after dental surgery.
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Distributor: Zuellig Pharma. COX-1 is responsible for prostaglandin-mediated normal physiologic functions such as gastric cytoprotection and platelet aggregation. Selective inhibition of COX-2 by etoricoxib decreases these clinical signs and symptoms with decreased GI toxicity and without effects on platelet function. The influence on gastroprotective COX-1 activity was also assessed in a clinical study where prostaglandin synthesis was measured in gastric biopsy samples from subjects administered either ARCOXIA mg daily, naproxen mg twice daily, or placebo. There was no inhibition of ex vivo arachidonic acid- or collagen-induced platelet aggregation at steady state with doses of ARCOXIA up to mg.
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In July the Pharmaceutical Benefits Advisory Committee rejected an application to list etoricoxib on the PBS for osteoarthritis, concluding that there was no demonstrated need to list another COX-2 selective NSAID and that etoricoxib appears to cause more episodes of hypertension than celecoxib. In most other respects the efficacy and safety of etoricoxib are similar to those of celecoxib.
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- After 12 weeks, placebo patients were evenly distributed to etoricoxib or celecoxib based on their initial enrollment randomization schedule.
Non-steroidal anti-inflammatory drugs NSAIDs, the mainstay for the symptomatic treatment of OA, are effective analgesic and anti-inflammatory agents, but have a side effect profile with known risk. Two week, multi-centre, randomized, double-blind, double-dummy, placebo-controlled, two-part studies were conducted at 74 centres each.
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The submission sought a section 85 restricted benefit listing for etoricoxib 60 mg tablets for the symptomatic treatment osteoarthritis. At the March meeting, the PBAC rejected a submission for a restricted benefit listing for etoricoxib for the symptomatic treatment of osteoarthritis 60 mg and rheumatoid arthritis 90 mg on the grounds of uncertainty over the comparative safety claim.
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