Do etoricoxib and indometacin have similar effects and safety for gouty arthritis? A meta-analysis of randomized controlled trials

Tzu-Min Lin,1,2,* Jia-En Chi,1,3,* Chi-Ching Chang,2,4,* Yi-No Kang1 1Center for Evidence-Based Medicine, Department of Education, Taipei Medical University Hospital, Taipei, Taiwan, Republic of China; 2Division of Rheumatology, Immunology and Allergy, Department of Internal Medicine, Taipei Medical...

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Main Authors: Lin TM, Chi JE, Chang CC, Kang YN
Format: Article
Language:English
Published: Dove Medical Press 2018-12-01
Series:Journal of Pain Research
Subjects:
Online Access:https://www.dovepress.com/do-etoricoxib-and-indometacin-have-similar-effects-and-safety-for-gout-peer-reviewed-article-JPR
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author Lin TM
Chi JE
Chang CC
Kang YN
author_facet Lin TM
Chi JE
Chang CC
Kang YN
author_sort Lin TM
collection DOAJ
description Tzu-Min Lin,1,2,* Jia-En Chi,1,3,* Chi-Ching Chang,2,4,* Yi-No Kang1 1Center for Evidence-Based Medicine, Department of Education, Taipei Medical University Hospital, Taipei, Taiwan, Republic of China; 2Division of Rheumatology, Immunology and Allergy, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan, Republic of China; 3School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, Republic of China; 4Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, Republic of China *These authors contributed equally to this work Background: Gout, a common medical condition that causes pain, can be treated by painkillers and anti-inflammatories. Indometacin and etoricoxib are two such drugs. However, no synthesized evidence exists comparing etoricoxib with indometacin in treating patients with gout.Methods: We searched PubMed, Embase, Ovid MEDLINE, Web of Science, ScienceDirect, and the Cochrane Library without restrictions on language or publication date for potential randomized clinical trials comparing etoricoxib with indometacin for gout. The meta-analysis was conducted using a random-effects model.Results: Search results yielded 313 references from six electronic databases, four of which met the eligibility criteria. These four were randomized clinical trials, and they involved a total of 609 patients with gouty arthritis. No significant differences were observed in pain score change, tenderness, or swelling between etoricoxib and indometacin; the mean differences were −0.05 (95% CI, −0.21 to 0.10), −0.06 (95% CI, −0.18 to 0.05), and −0.04 (95% CI, −0.17 to 0.09). However, the pooled data revealed that significantly fewer overall adverse events occurred in the etoricoxib group (n=105, 33.5%) than in the indometacin group (n=130, 44.1%) and the risk ratio was 0.77 (95% CI, 0.62–0.94).Conclusion: Our meta-analysis revealed that etoricoxib and indometacin have similar effects on pain relief. However, etoricoxib has a significantly lower risk of adverse events than does indometacin, especially digestive system-related adverse events. Keywords: gout, etoricoxib, indometacin 
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spelling doaj.art-53cf5867a2d84970be99016c62a9b3582022-12-22T03:56:43ZengDove Medical PressJournal of Pain Research1178-70902018-12-01Volume 12839143136Do etoricoxib and indometacin have similar effects and safety for gouty arthritis? A meta-analysis of randomized controlled trialsLin TMChi JEChang CCKang YNTzu-Min Lin,1,2,* Jia-En Chi,1,3,* Chi-Ching Chang,2,4,* Yi-No Kang1 1Center for Evidence-Based Medicine, Department of Education, Taipei Medical University Hospital, Taipei, Taiwan, Republic of China; 2Division of Rheumatology, Immunology and Allergy, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan, Republic of China; 3School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, Republic of China; 4Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, Republic of China *These authors contributed equally to this work Background: Gout, a common medical condition that causes pain, can be treated by painkillers and anti-inflammatories. Indometacin and etoricoxib are two such drugs. However, no synthesized evidence exists comparing etoricoxib with indometacin in treating patients with gout.Methods: We searched PubMed, Embase, Ovid MEDLINE, Web of Science, ScienceDirect, and the Cochrane Library without restrictions on language or publication date for potential randomized clinical trials comparing etoricoxib with indometacin for gout. The meta-analysis was conducted using a random-effects model.Results: Search results yielded 313 references from six electronic databases, four of which met the eligibility criteria. These four were randomized clinical trials, and they involved a total of 609 patients with gouty arthritis. No significant differences were observed in pain score change, tenderness, or swelling between etoricoxib and indometacin; the mean differences were −0.05 (95% CI, −0.21 to 0.10), −0.06 (95% CI, −0.18 to 0.05), and −0.04 (95% CI, −0.17 to 0.09). However, the pooled data revealed that significantly fewer overall adverse events occurred in the etoricoxib group (n=105, 33.5%) than in the indometacin group (n=130, 44.1%) and the risk ratio was 0.77 (95% CI, 0.62–0.94).Conclusion: Our meta-analysis revealed that etoricoxib and indometacin have similar effects on pain relief. However, etoricoxib has a significantly lower risk of adverse events than does indometacin, especially digestive system-related adverse events. Keywords: gout, etoricoxib, indometacin https://www.dovepress.com/do-etoricoxib-and-indometacin-have-similar-effects-and-safety-for-gout-peer-reviewed-article-JPRGoutGouty arthritisEtoricoxibIndometacin
spellingShingle Lin TM
Chi JE
Chang CC
Kang YN
Do etoricoxib and indometacin have similar effects and safety for gouty arthritis? A meta-analysis of randomized controlled trials
Journal of Pain Research
Gout
Gouty arthritis
Etoricoxib
Indometacin
title Do etoricoxib and indometacin have similar effects and safety for gouty arthritis? A meta-analysis of randomized controlled trials
title_full Do etoricoxib and indometacin have similar effects and safety for gouty arthritis? A meta-analysis of randomized controlled trials
title_fullStr Do etoricoxib and indometacin have similar effects and safety for gouty arthritis? A meta-analysis of randomized controlled trials
title_full_unstemmed Do etoricoxib and indometacin have similar effects and safety for gouty arthritis? A meta-analysis of randomized controlled trials
title_short Do etoricoxib and indometacin have similar effects and safety for gouty arthritis? A meta-analysis of randomized controlled trials
title_sort do etoricoxib and indometacin have similar effects and safety for gouty arthritis a meta analysis of randomized controlled trials
topic Gout
Gouty arthritis
Etoricoxib
Indometacin
url https://www.dovepress.com/do-etoricoxib-and-indometacin-have-similar-effects-and-safety-for-gout-peer-reviewed-article-JPR
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