Minimum efficacy criteria for comparisons between treatments using individual patient meta-analysis of acute pain trials: examples of etoricoxib, paracetamol, ibuprofen/paracetamol combinations after third molar extraction
We defined response in acute pain trials to percentage of maximum possible efficacy. Minimum efficacy criteria (MEC) of 0%, or at least 15%, 30%, 50%, and 70% pain relief were used to examine stability over time using total pain relief and summed pain intensity difference (SPID), sex differences, an...
| Main Authors: | , , , , |
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| Other Authors: | |
| Format: | Journal article |
| Language: | English |
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Elsevier
2011
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| _version_ | 1797085620269481984 |
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| author | Moore, R Straube, S Paine, J Derry, S McQuay, H |
| author2 | International Association for the Study of PainOxford Pain Relief Trust |
| author_facet | International Association for the Study of PainOxford Pain Relief Trust Moore, R Straube, S Paine, J Derry, S McQuay, H |
| author_sort | Moore, R |
| collection | OXFORD |
| description | We defined response in acute pain trials to percentage of maximum possible efficacy. Minimum efficacy criteria (MEC) of 0%, or at least 15%, 30%, 50%, and 70% pain relief were used to examine stability over time using total pain relief and summed pain intensity difference (SPID), sex differences, and sensitivity. We used individual patient data from placebo-controlled third molar extraction trials: 4 with single-dose oral etoriocoxib 120 mg, and 2 with paracetamol, ibuprofen, and ibuprofen plus paracetamol combinations. With etoricoxic, numbers needed to treat (NNTs) were stable between response levels of at least 15% (MEC15) and 50% pain relief (MEC50), and similar for total pain relief and SPID. NNTs were higher (worse) at extremes of MEC, especially with SPID. Results for women and men were similar. NNTs of lower efficacy treatments (paracetamol 500 and 1000 mg) rose rapidly at higher MEC. NNTs of high efficacy treatments (ibuprofen plus paracetamol combinations) showed greater separation at higher MEC. The highest degree of discrimination between treatments was with MEC50 and MEC70. Etoricoxib 120 mg (NNT for ≥ 50% maximum 6-hour pain relief 1.7) and ibuprofen 200/400 mg plus paracetamol 500/1000 mg (NNTs 1.5 and 1.6, respectively) produced the lowest (best) NNTs in the dental pain model. Timing of patient request for additional analgesia is an alternative analgesic efficacy outcome measure. |
| first_indexed | 2024-03-07T02:11:03Z |
| format | Journal article |
| id | oxford-uuid:a0ab5124-9ca5-4191-ae12-320e8c32af10 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T02:11:03Z |
| publishDate | 2011 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:a0ab5124-9ca5-4191-ae12-320e8c32af102022-03-27T02:07:01ZMinimum efficacy criteria for comparisons between treatments using individual patient meta-analysis of acute pain trials: examples of etoricoxib, paracetamol, ibuprofen/paracetamol combinations after third molar extractionJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:a0ab5124-9ca5-4191-ae12-320e8c32af10AnaestheticsEnglishOxford University Research Archive - ValetElsevier2011Moore, RStraube, SPaine, JDerry, SMcQuay, HInternational Association for the Study of PainOxford Pain Relief TrustWe defined response in acute pain trials to percentage of maximum possible efficacy. Minimum efficacy criteria (MEC) of 0%, or at least 15%, 30%, 50%, and 70% pain relief were used to examine stability over time using total pain relief and summed pain intensity difference (SPID), sex differences, and sensitivity. We used individual patient data from placebo-controlled third molar extraction trials: 4 with single-dose oral etoriocoxib 120 mg, and 2 with paracetamol, ibuprofen, and ibuprofen plus paracetamol combinations. With etoricoxic, numbers needed to treat (NNTs) were stable between response levels of at least 15% (MEC15) and 50% pain relief (MEC50), and similar for total pain relief and SPID. NNTs were higher (worse) at extremes of MEC, especially with SPID. Results for women and men were similar. NNTs of lower efficacy treatments (paracetamol 500 and 1000 mg) rose rapidly at higher MEC. NNTs of high efficacy treatments (ibuprofen plus paracetamol combinations) showed greater separation at higher MEC. The highest degree of discrimination between treatments was with MEC50 and MEC70. Etoricoxib 120 mg (NNT for ≥ 50% maximum 6-hour pain relief 1.7) and ibuprofen 200/400 mg plus paracetamol 500/1000 mg (NNTs 1.5 and 1.6, respectively) produced the lowest (best) NNTs in the dental pain model. Timing of patient request for additional analgesia is an alternative analgesic efficacy outcome measure. |
| spellingShingle | Anaesthetics Moore, R Straube, S Paine, J Derry, S McQuay, H Minimum efficacy criteria for comparisons between treatments using individual patient meta-analysis of acute pain trials: examples of etoricoxib, paracetamol, ibuprofen/paracetamol combinations after third molar extraction |
| title | Minimum efficacy criteria for comparisons between treatments using individual patient meta-analysis of acute pain trials: examples of etoricoxib, paracetamol, ibuprofen/paracetamol combinations after third molar extraction |
| title_full | Minimum efficacy criteria for comparisons between treatments using individual patient meta-analysis of acute pain trials: examples of etoricoxib, paracetamol, ibuprofen/paracetamol combinations after third molar extraction |
| title_fullStr | Minimum efficacy criteria for comparisons between treatments using individual patient meta-analysis of acute pain trials: examples of etoricoxib, paracetamol, ibuprofen/paracetamol combinations after third molar extraction |
| title_full_unstemmed | Minimum efficacy criteria for comparisons between treatments using individual patient meta-analysis of acute pain trials: examples of etoricoxib, paracetamol, ibuprofen/paracetamol combinations after third molar extraction |
| title_short | Minimum efficacy criteria for comparisons between treatments using individual patient meta-analysis of acute pain trials: examples of etoricoxib, paracetamol, ibuprofen/paracetamol combinations after third molar extraction |
| title_sort | minimum efficacy criteria for comparisons between treatments using individual patient meta analysis of acute pain trials examples of etoricoxib paracetamol ibuprofen paracetamol combinations after third molar extraction |
| topic | Anaesthetics |
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