Publication:

Comparative study of effectiveness and safety of nonsteroidal anti-inflammatory drugs in patients of knee joint osteoarthritis of knee, tertiary care hospital, Bidar, India

Background Osteoarthritis (OA) is a joint failure and OA is the most frequent chronic joint disease causing pain and disability. Where all the structures of joints have undergone pathological changes and they are hyaline articular cartilage loss which may be focal or non-uniform, initially it will be focal then spread all over non-uniformly. Non-Steroidal Anti Inflammatory Drugs (NSAID) are the mainstay of medical management of OA. Increased in reports suggests that GIT adverse effect with old NSAID’s and cardiovascular effects with selective cyclooxygenase-2 (COX2) inhibitors had precipitated to chase for better NSAID’s with minimal adverse effects. The current study compares the clinical effectiveness and safety of newer NSAID’s, etoricoxib, lornoxicam, to diclofenac which has been standard therapy in patients of OA of the knee joint.

Methods The current study is randomized, prospective, open-label, parallel group study conducted in 120 patients with OA of the knee joint diagnosed using American College of Rheumatology criteria. After getting the informed consent, they were randomized in three groups of 40 patients each who received tablet etoricoxib 120mg BID, tablet Lornoxicam 16mg BID, tablet diclofenac 50mg TID respectively. The duration of the study is 12 weeks. Data are calculated, tabulated and analyzed using analysis of variance (ANOVA) test, and level of significance was determined by its P value.

Results After 12weeks of treatment, the severity of pain and functional indices using visual analog scale and Western Ontario and McMaster Universities Osteoarthritis score were significantly better (P <0.05) in etoricoxib group as compared to lornoxicam or diclofenac group along with a lesser rate of adverse effects.

Conclusions It is concluded that etoricoxib is more effective and tolerated NSAID than lornoxicam and diclofenac in the treatment of knee joint OA.