Etoricoxib, a highly selective COX-2 inhibitor, was evaluated in two recent trials: one for patients with rheumatoid arthritis, the other for patients with acute gouty arthritis.
In the first study, conducted for the Etoricoxib Rheumatoid Arthritis Study Group, 687 patients completed 12 weeks of treatment with placebo, etoricoxib 90 mg/day, or naproxen 500 mg BID. The study was conducted at 67 sites in 28 countries. Compared with patients on placebo, patients in both drug groups showed significant improvements in all endpoints. Similar percentages (58% and 59%) of naproxen and etoricoxib patients, respectively, responded according to American College of Rheumatology criteria: tender joint and swollen joint counts, patient and investigator assessment of disease activity. Etoricoxib treatment effects were rapid, the investigators say, occurring at the earliest time measured (week two) and were maintained over the entire study period. Both drugs were similarly well-tolerated. Only three serious clinical adverse events were judged to be drug-related: two patients on etoricoxib (duodenal ulcer and hip pain), and one on naproxen (hypertension).
In the second trial, of 150 patients in 11 countries with acute gouty arthritis, a once-daily dose of etoricoxib 120 mg worked as well for symptoms as did indometacin 50 mg three times daily for eight days. There were also controls for each drug. Both etoricoxib and indometacin groups experienced comparable pain relief, starting four hours after the initial dose. The two drugs were well-tolerated. Four patients in the indometacin group reported serious adverse events (vomiting and headache). Etoricoxib was associated with a lower incidence of drug-related adverse events (P=0.003) than indometacin.