Efficacy and tolerability of celecoxib in the treatment of acute gouty arthritis: a randomized controlled trial.

Abstract

OBJECTIVE:

To evaluate the analgesic efficacy of high-dose celecoxib in the treatment of moderate to extreme pain and inflammation associated with acute gouty arthritis.

METHODS:

A multinational, randomized, double-blind, double-dummy, active-controlled trial was done with patients (aged≥18 years) with acute gouty monoarthritis or oligoarthritis (onset of pain≤48 h before enrollment). Patients were treated for 8 days with 1 week followup and were randomized 1:1:1:1 to receive celecoxib 50 mg bid, celecoxib 400 mg (followed by 200 mg later on Day 1 and then 200 mg bid for 7 days), celecoxib 800 mg (followed by 400 mg later on Day 1 and then 400 mg bid for 7 days), or indomethacin 50 mg tid.

RESULTS:

Of 443 patients screened, 402 were randomized and 400 received treatment. Baseline demographics were comparable among treatments. Patients receiving high-dose celecoxib (800/400 mg) experienced a significantly greater reduction in pain intensity on Day 2 compared with low-dose celecoxib 50 mg bid [least squares (LS) mean difference -0.46; p=0.0014]. For high-dose celecoxib 800/400 mg, the change in pain scores from baseline to Day 2 was comparable with indomethacin 50 mg tid (LS mean difference 0.11; p=0.4331). There were significant differences in adverse events when the combined celecoxib groups (29.5%) were compared with patients taking indomethacin (43.1%; p=0.0116). There was no change in median serum creatinine levels for any treatment. There were more discontinuations due to adverse events (8.8% vs 3%; p=0.0147) with indomethacin than with the combined celecoxib groups.

CONCLUSION:

High-dose celecoxib (800/400 mg) was significantly more effective than low-dose celecoxib (50 mg bid) and comparable to indomethacin in the treatment of moderate to extreme pain in patients with acute gouty arthritis. Further, celecoxib was well tolerated.

• Authors: H Ralph Schumacher, Manuela F Berger, Julie Li-Yu, Fernando Perez-Ruiz, Rubén Burgos-Vargas, Chunming Li
• Journal: The Journal of rheumatology (J Rheumatol) Vol. 39 Issue 9 Pg. 1859-66 (Sep 2012) ISSN: 0315-162X [Print] Canada
• PMID: 22859357 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Cyclooxygenase 2 Inhibitors
• Pyrazoles
• Sulfonamides
• Celecoxib

Topics

• Adult
• Aged
• Aged, 80 and over
• Arthritis, Gouty (drug therapy)
• Celecoxib
• Cyclooxygenase 2 Inhibitors (administration & dosage, adverse effects, therapeutic use)
• Dose-Response Relationship, Drug
• Double-Blind Method
• Female
• Humans
• Male
• Middle Aged
• Pain Measurement
• Pyrazoles (administration & dosage, adverse effects, therapeutic use)
• Sulfonamides (administration & dosage, adverse effects, therapeutic use)
• Treatment Outcome