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SAT0512 Does Switching from One Non-Steroidal Anti-Inflammatory Drug (NSAID) To Another Improve Pain Control?
  1. A. Karateev,
  2. N. Gontarenko,
  3. A. Tsurgan
  1. V. A. Nasonova Research Institute of Rheumatology, Moscow, Russian Federation

Abstract

Background NSAIDs - the main medications for control of musculoskeletal pain in rheumatic diseases (RD). However, their use does not always lead to a significant reduction of pain and may be accompanied by side effects. There is a need to replace the first NSAID with another in many patients.

Objectives To evaluate the results of the use of the selective COX-2 inhibitor etoricoxib in patients with acute/subacute pain related to background RD despite using other NSAIDs.

Methods A group of patients of 1566 patients (63.5% women and 31.1% men, age 48.8 ± 13.9 years) with acute/subacute pain associated with RD (mainly osteoarthritis and back pain) was included in an open-label study. The criterion for selection of patients was dissatisfaction with the treatment (10 cm VAS pain >3 cm) by background NSAIDs. The patients mainly used diclofenac (24.5%), nimesulide (27.2%) and meloxicam (25.6%). After inclusion in the study all patients started etoricoxib instead of other NSAIDs. The dose and duration of treatment were determined by a physician: the majority of patients (59.6%) took etoricoxib 90 mg/day. The results of treatment were assessed after 2 weeks.

Results After start of treatment with etoricoxib a significant improvement was observed in the majority of patients. Pain decreased from 6.21 ± 1.4 to 1.93 ± 1.3 cm VAS. The complete pain relief was achieved in 12.5% of patients, 58.3% achieved low intensity of pain (VAS <2 cm). Additional therapy for symptom control (muscle relaxants, other analgesics, local injections of glucocorticoids, and others) needed in 31.2% of patients. The best effect was observed when using a higher dose of etoricoxib: decrease of pain intensity on 120 mg, 90 mg and 60 mg per day was 4.77 ± 1.88, 4.69 ± 2.01 and 3.50 ± 1.48 cm VAS respectively (the difference between 120 and 60 mg/day, 90 and 60 mg/day was significant, p<0.001). Treatment tolerability was assessed as “good” in 62.7%, "satisfactory" in 36.7% and "bad" in 0.6% of patients. Adverse events were reported in 55 patients (3.5%), mainly dyspepsia – in 21 (1.3%) and arterial hypertension - in 27 patients (1.7%).

Conclusions Switching from previous therapy with NSAIDs to etoricoxib provides an effective reduction of acute/subacute pain. High doses etoricoxib are more effective. Short-term use of etoricoxib rarely causes adverse events.

Disclosure of Interest None declared

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