Continuous celecoxib may have edge in OA therapy
Last Updated: 2007-01-24 10:37:46 -0400 (Reuters Health)
By David Douglas
NEW YORK (Reuters Health) - Continuous treatment with celecoxib appears to generally provide somewhat more favorable results than does an intermittent dosing approach in patients with knee or hip osteoarthritis (OA). However, the differences are not significant, Belgian researchers report in the January issue of Annals of the Rheumatic Diseases.
Dr. Frank P. Luyten of University Hospitals KULeuven and colleagues speculated that intermittent treatment might reduce OA symptoms without causing the adverse events associated with continuous treatment. "In OA, it is wise to first try to control symptoms and signs with an intermittent treatment approach," Dr. Luyten told Reuters Health.
To investigate further, the researchers studied 123 patients who were randomized to continuous or intermittent treatment with celecoxib 200 mg. All patients were treated for at least 7 days and continued treatment until symptoms of OA flare resolved or after a maximum of 21 days.
In the absence of a flare, patients in the continuous group went on receiving celecoxib for 24 weeks. The intermittent group switched to placebo and active treatment was used only during OA flare.
At 24 weeks there were no significant between-group differences in Western Ontario, McMaster Universities Osteoarthritis Index and other measures.
However, patients in the intermittent treatment group took 0.68 rescue tablets daily versus 0.50 for patients in the continuous group. Moreover, 15% of patients in the intermittent group dropped out of the study because of treatment failure versus 8% of those in the continuous group.
In addition, more patients in the continuous group than in the intermittent group rated their treatment as good or very good.
Nevertheless, Dr. Luyten added that "it is my experience that most patients have a clear preference for intermittent treatment," which provides sufficient benefit.
Intermittent treatment, he concluded, also provides the patient with sufficient benefits" without the need for as much medication.
Ann Rheum Dis 2007;66:99-106.
