Etoricoxib 30mg tablets

IntroductionOsteoarthritis (OA) as a degenerative disease, has seen a continuous rise in incidence and prevalence globally since 1990, imposing a significant disease burden. NSAIDs (Nonsteroidal anti-inflammatory drugs) as symptomatic medications for OA treatment, hold an indispensable position in clinical practice.ObjectiveTo evaluate the efficacy and safety of different NSAIDs in the treatment of OA through Bayesian Network Meta-Analysis (NMA).MethodsRandomized controlled trials (RCTs) on NSAIDs for OA treatment were retrieved from PubMed, Web of Science, Embase, and the Cochrane Library databases. The search timeframe was from the inception of each database up to June 1, 2024. Outcome indicators for NMA were all conducted using a random-effects model. MetaInsight and Stata 14.0 software were used in R for calculations and plotting of NMA. Measurement data were represented by mean difference (MD), and count data by odds ratio (OR); a 95% confidence interval (CI) was also calculated for each effect size.ResultsThis study included 31 studies, involving 68,539 patients with knee osteoarthritis (KOA) and 16 interventions. NMA results showed that compared to the placebo, Tiaprofenic reduced the VAS score (MD =  -0.16, 95% CI: (-0.46 to 0.14), P >  0.05), albeit without significant difference; meanwhile, Diclofenac reduced the total WOMAC score in KOA patients (MD =  -0.41, 95% CI: -1.05 to 0.24, P >  0.05). Compared to the placebo, Etoricoxib was the best medication for improving the WOMAC pain subscale score (MD =  -0.44; 95% CI: -0.61 to -0.26); Naproxen significantly improved the WOMAC Function score in KOA patients after administration (MD = -0.43; 95% CI: -0.82 to -0.04); Diclofenac intervention significantly reduced the WOMAC Stiffness score in KOA patients (MD =  -0.40; 95% CI: -0.67 to -0.13). In terms of adverse event rates, compared to the placebo, the use of Etoricoxib significantly increased the incidence of cardiovascular adverse events (OR =  0.56, 95% CI: 0.32-0.99); Ketoprofen had fewer gastrointestinal adverse events during the medication process (OR =  0.09, 95% CI: 0.04-0.20); Licofelone had a lower rate of other adverse events during the medication process (OR =  0.80, 95% CI: 0.45-1.40, P >  0.05). Therefore, the results indicate that Etoricoxib, Tiaprofenic, Naproxen, Diclofenac, and Ketoprofen have better clinical efficacy and safety.ConclusionCompared to other NSAIDs, Etoricoxib, Tiaprofenic, Naproxen, and Diclofenac play a more effective role in improving clinical symptoms of OA; in terms of reducing the incidence of adverse events, Ketoprofen has a lower chance of adverse events. However, the possibility of these results still needs further clinical and basic research for verification.

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Introduction: Periodontal procedures can promote prolonged intense pain, particularly in clinical situations requiring surgical procedures. In this context, preemptive analgesia has also been assessed for its utility in controlling post-operative pain and discomfort in patients undergoing periodontal invasive procedures. This study assessed the efficacy and safety of preemptive oral analgesia with steroidal and non-steroidal anti-inflammatory drugs in periodontal surgeries. Methods: This systematic review performed a search in the following electronic sources: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (via PubMed), EMBASE (via Ovid), Web of Science, Virtual Health Library and in clinical trials electronic databases for relevant randomized clinical trials (RCTs); published up to July 2023. Primary outcomes assessed were post-operative pain, edema and trismus. A narrative synthesis of the findings was carried out. Results: Six RCTs, involving a total of 250 participants, were included. The studies reviewed had a high risk of bias, particularly due to allocation concealment and blinding of participants and personnel. The RCTs reported only the outcome pain. The preemptive use of dexamethasone 8 mg, etoricoxib 90 mg or 120 mg and ketorolac 20 mg seems to be more effective for controlling post-operative pain than placebo. Discussion: The anti-inflammatory drugs evaluated proved to be effective for controlling post-operative pain. However, given the limitations regarding lack of studies, methodological biases, disparities in drugs and doses, report restricted the pain outcome; further RCTs confirming the effectiveness and safety of these drugs in periodontal surgical procedures are warranted.

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BackgroundHeterotopic ossification (HO) involves the ectopic deposition of bone in soft tissues, frequently occurring as a complication post-hip trauma or surgery. To prevent HO following total hip arthroplasty (THA), irradiation has been extensively employed, alongside the use of nonsteroidal anti-inflammatory drugs (NSAIDs). Given the extensive range of NSAIDs available, determining the most effective NSAID or irradiation protocol for prophylaxis continues to be a matter of debate.MethodsAdhering to the PRISMA guidelines, a comprehensive search was conducted across PubMed, Embase, Cochrane Library, and Web of Science to identify relevant randomized controlled trials. To minimize bias in literature evaluation, two authors independently searched and assessed the articles. In cases of disagreement, a third author was consulted. We strictly implement the inclusion and exclusion criteria. Using the criteria for assessing bias in the Cochrane Collaboration Network, two writers independently evaluated the quality of the included studies. We systematically extracted and assessed data according to the level of evidence presented in the articles. A Bayesian network meta-analysis (NMA) was implemented to evaluate and contrast the efficacy of irradiation and six distinct NSAIDs in preventing HO after THA. The results were computed using the GEMTC package in R (V.4.4.1). The consistency of the model was tested using nodal analysis. The priority of drug efficacy was comprehensively evaluated using rank probability and the surface under the cumulative ranking curve (SUCRA). Stata 16 was used to assess publication bias, and sensitivity analysis was performed using the one-by-one elimination method. The protocol for this study was officially registered with the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY).ResultsA total of 461 studies were identified, and 17 studies were finally included in the analysis. The meta-analysis incorporated data from 3,014 patients: 629 administered ibuprofen, 54 with naproxen, 117 receiving celecoxib, 426 on indomethacin, 295 treated with diclofenac, 45 on etoricoxib, 522 subjected to irradiation, and 926 serving as controls. These trials reported an average age ranging from 59 to 75 years, with males comprising 31.2%-63% of subjects. The total incidence rate of HO in all control groups was 55.2%. In terms of effectiveness, compared with the control, four strategies showed a low incidence of HO, including naproxen (OR = 0.08, 95% CrI 0.01-0.60), indomethacin (OR = 0.13, 95% CrI 0.04-0.41), diclofenac (OR = 0.06, 95% CrI 0.01-0.29), and irradiation (OR = 0.08, 95% CrI 0.02-0.3). Diclofenac was more beneficial than ibuprofen (OR = 0.10, 95% CrI 0.01-0.97). The probabilities derived from the surface under the cumulative ranking curve (SUCRA) algorithm are as follows: Diclofenac (78.0%), etoricoxib (71.6%), irradiation (67.3%), naproxen (66.7%), indomethacin (53.2%), celecoxib (38.8%), ibuprofen (18.6%), and a control group (6.8%). Because stronger evidence supports the efficacy of diclofenac. The most likely ranking for the effectiveness of preventing HO after THA is as follows: Diclofenac > etoricoxib > irradiation > naproxen > indomethacin > celecoxib > ibuprofen.ConclusionIn terms of preventive efficacy, diclofenac and etoricoxib demonstrated the most favorable performance in preventing HO after THA within this network meta-analysis. Irradiation, naproxen, and indomethacin are also satisfactory options, while ibuprofen is ineffective. Given the advantages shown by etoricoxib and celecoxib, further randomized controlled trials are recommended to clarify their effects. Our conclusions require confirmation through additional high-quality studies.

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BackgroundThough postoperative acute pain following third molar extraction impairs patient satisfaction and increases health care costs, evidence regarding the efficacy of the highly selective cyclooxygenase-2 inhibitor etoricoxib for preemptive analgesia in this setting remains unclear.PurposeThe purpose of this study was to measure the association of etoricoxib preemptive analgesia on pain and functional recovery after third molar surgery.Data sourcesThe databases CENTRAL, MEDLINE, Embase, Scopus, Web of Science, CNKI, and WANFANG were searched from inception to March 2025 (English and Chinese) using the keywords "Etoricoxib" and "Third Molar."Study selectionRandomized controlled trials (RCTs) comparing etoricoxib with placebo for third molar extraction were included; non-RCTs and reviews were excluded. Three researchers independently screened the literature.Data extraction and synthesisThis study is a systematic review and meta-analysis. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used for data extraction. The Cochrane tool assessed risk of bias. Review Manager 5.4.1 analyzed data, applying fixed- or random-effects models according to heterogeneity.Main outcomesThe predictor variable was preoperative intervention type (etoricoxib vs placebo). The outcome variables were postoperative pain and functional recovery: pain was assessed by visual analog scale (VAS) scores (1 to 144 hours postoperatively), postoperative analgesic consumption, time to first analgesic use, and proportion of subjects using rescue analgesics; functional recovery was measured by degree of facial edema and maximum mouth opening. Covariates included surgical difficulty, etoricoxib dosage, and timing of preoperative administration.ResultsSix RCTs involving 456 subjects (aged 18 to 44 years) were included. VAS scores were lower in the etoricoxib group (1 to 6 hours: mean difference [MD] = -2.33; 8 to 24 hours: MD = -1.31, both P 2 = 0%).ConclusionsPreoperative administration of etoricoxib was associated with reduced acute postoperative pain and improved functional recovery. A preoperative dose of 120 mg of etoricoxib was correlated with more favorable analgesic and functional outcomes for complex third molar extractions compared with lower doses.

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ObjectivesTo assess the efficacy of naproxen, ibuprofen, ketoprofen, diclofenac, etoricoxib and celecoxib in low back pain with or without radiculalgia.MethodSystematic review and meta-analysis of randomised controlled trials (RCTs) using the REB method. Eligibility criteria were RCTs assessing the painkiller efficacy of the aforementioned non-steroidal anti-inflammatory drugs (NSAIDs) administered orally versus placebo, in acute and chronic low back pain with or without radiculalgia. The literature search was conducted on Medline, Cochrane Central Register of Controlled Trials, and ClinicalTrial.gov until 31/12/2024. The risks of bias were assessed using the tool Risk of Bias 2 (RoB2) from the Cochrane collaboration. In addition to the qualitative analysis using the REB method, a quantitative analysis was conducted using Review Manager v5.4. The standardised mean differences (SMD) were calculated with a 95% confidence interval (95% CI). Statistical significance was met if the P-value wasResultsA total of 11 RCTs were identified: 6 concerned acute low back pain and 5 chronic low back pain. Six were at low risk of bias for pain intensity, and 4 at low risk of bias for functional capacity; 5 were at high risk of bias for pain intensity and 5 at high risk of bias for functional capacity. Three thousand seven hundred eighty-four (3784) patients were included: 2142 suffered from chronic low back pain and 1642 from acute low back pain. The REB analysis concluded "solid evidence of efficacy" for diclofenac in acute low back pain. For the ibuprofen in acute low back pain without radiculalgia, the results were "conclusive to be confirmed". For the naproxen in acute low back pain with radiculalgia, the results were "conclusive to be confirmed". For the other treatments and indications, the conclusion was "lack of evidence".DiscussionThis review has several limitations: a small number of trials that evaluated NSAIDs versus placebo, which limits the interpretation of possible publication bias by the interpretation of funnel plots. More than half of the selected trials aimed to evaluate a different active ingredient or treatment, with the NSAIDs studied primarily used as comparators. Only trials published in French and English were included, which may have introduced selection bias. Furthermore, the results of the RCTs often focused on secondary rather than primary endpoints. Of the 6 NSAIDs studied, only diclofenac showed solid evidence of efficacy on pain intensity in acute low back pain. Ibuprofen and Naproxen showed conclusive evidence requiring confirmation. For the other drugs, there was no evidence of efficacy according to the REB method. For all the analyses, the magnitude of the effect was small and not clinically relevant. It is necessary to conduct new RCTs to confirm the clinical interest of NSAIDs in acute and chronic low back pain.

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Objective 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). Methods Studies were searched in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials from inception to August 2017. Randomized Clinical Trials (RCTs) that compared etoricoxib with placebo and other active drug for patients with OA or RA and reported data on gastrointestinal safety (which is of interest to patients and clinicians) were included. The follow-up time window for GAEs was defined as within 28 days subsequent to the last dose of study medication. A meta-analysis was conducted using a fixed-effect model. Risk ratios (RRs) and 95% confidence intervals (CIs) were measured. Results We found nine randomized clinical trials (RCTs) that included information on gastrointestinal safety during follow-up time. Among them, five RCTs compared etoricoxib with placebo, four RCTs compared etoricoxib with diclofenac, and three RCTs compared etoricoxib with naproxen. Etoricoxib did not increase the risk of GAEs compared with placebo. Compared with diclofenac and naproxen, etoricoxib reduced the GAE risk (RR, 0.67; 95% CI, 0.59–0.76; p < 0.00001; 0.59; 0.48–0.72; < 0.00001) during follow-up time. Conclusions In patients with OA or RA, etoricoxib did not increase the GAE risk compared with placebo, but reduced the GAE risk effectively compared with diclofenac and naproxen during follow-up time.

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Firsekibart, an anti-interleukin (IL)-1β monoclonal antibody, has demonstrated more sustained control of gout flares compared with compound betamethasone in previous clinical studies. This study evaluated the efficacy and safety of firsekibart versus etoricoxib for the treatment of frequent gout flares. In this phase 2, randomized, open-label, active-controlled, multicenter study (NCT05936268), adults with gout according to American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) 2015 criteria experiencing frequent flares (≥ 2 flares within 12 months pre-screening) were randomized (1:1) to receive either a single subcutaneous injection of firsekibart 200 mg, or once-daily oral etoricoxib 120 mg administered until pain remission or treatment intolerance for up to 8 days. The primary endpoint was change from baseline in target joint pain intensity (0–100 mm visual analogue scale [VAS]) 72 h post-treatment. Non-inferiority (margin: 10 mm) was assessed first; if achieved, superiority was subsequently evaluated. Safety was also evaluated. Overall, 123 patients received firsekibart (n = 61) or etoricoxib (n = 62). Firsekibart was non-inferior and superior to etoricoxib in change from baseline in target joint pain VAS scores at 72 h post-treatment (difference: − 10.91 mm; 95% confidence interval [CI]: − 18.11, − 3.72). Treatment-emergent adverse events (TEAEs) occurred in 77.0% (n = 47) and 51.6% (n = 32) of patients receiving firsekibart and etoricoxib, respectively. The most common TEAE in both groups was hypertriglyceridemia. No TEAEs led to treatment discontinuation or study withdrawal, and no treatment-related serious adverse events (AEs) or deaths were reported. Compared with etoricoxib, firsekibart provides superior target joint pain relief and is well-tolerated in patients with frequent gout flares. ClinicalTrials.gov identifier: NCT05936268; date of registration: 7 July 2023.

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