Cardiovascular and Gastrointestinal Effects of Etoricoxib in the Treatment of Osteoarthritis: A Systematic Review and Network Meta-analysis.
10.4078/jrd.2017.24.5.293
- Author:
Dam KIM
1
;
Soo Kyung CHO
;
Seoung Wan NAM
;
Hyuk Hee KWON
;
Sun Young JUNG
;
Chan Hong JEON
;
Seul Gi IM
;
Dalho KIM
;
Eun Jin JANG
;
Yoon Kyoung SUNG
Author Information
1. Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea. sungyk@hanyang.ac.kr
- Publication Type:Meta-Analysis ; Original Article
- Keywords:
Anti-inflammatory agents;
non-steroidal;
Etoricoxib;
Osteoarthritis;
Safety
- MeSH:
Anti-Inflammatory Agents;
Anti-Inflammatory Agents, Non-Steroidal;
Celecoxib;
Ibuprofen;
Incidence;
Naproxen;
Osteoarthritis*
- From:Journal of Rheumatic Diseases
2017;24(5):293-302
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To estimate the cardiovascular (CV) and gastrointestinal (GI) risks of etoricoxib in the treatment of osteoarthritis (OA) compared to a placebo and other non-steroidal anti-inflammatory drugs (NSAIDs). METHODS: A systematic review of randomized, controlled trials (RCTs) of etoricoxib were performed. Bayesian network meta-analysis was used over a duration of 12 weeks. The incidence of CV and GI events for a duration ≥26 weeks were also tabulated and presented using descriptive statistics. RESULTS: From this search, 10 studies were identified. Of these, 6 and 5 RCTs that measured the CV and GI events at 12 weeks were included in meta-analysis. They showed that etoricoxib did not increase the CV events compared to the placebo or NSAIDs during the 12 week period (odds ratio [OR]=0.59 compared to celecoxib, OR=0.89 with ibuprofen, OR=0.70 with placebo, and OR=2.16 with naproxen). The risk of GI events was comparable to that of most comparators, with the exception of naproxen, which had a significantly lower risk of GI events (OR=0.18) during the 12 week period. For a duration ≥26 weeks, the incidence of CV and GI events with etoricoxib increased with increasing duration. CONCLUSION: Etoricoxib is an alternative short-term treatment option for OA, showing comparable CV and GI complications to other NSAIDs. Nevertheless, further studies will be needed to elucidate the long-term safety of etoricoxib in the treatment of OA.