Efficacy and Safety of Celecoxib Therapy in Osteoarthritis: A Meta-Analysis of Randomized Controlled Trials

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Abstract

Osteoarthritis (OA) is the most common form of arthritis in older individuals and is among the most prevalent and disabling chronic conditions worldwide.

We conducted a meta-analysis to determine the efficacy and safety of celecoxib, a cyclooxygenase-2 (COX-2) inhibitor in the treatment of osteoarthritis. Studies were pooled, and mean difference (MD), relative risk (RR), and its corresponding 95% confidence interval (CI) were calculated. Fifteen relevant articles were included for this meta-analysis study.

We observed that osteoarthritis total score (MD = −4.41, 95% CI −7.27 to −1.55), pain subscale score (MD = −0.86, 95% CI −1.10 to −0.62), and function subscale score (MD = −2.90, 95% CI −5.12 to −0.67) in OA patients treatment with celecoxib was significantly improved than that with placebo. There was no significant difference in the incidence of adverse events (AEs), SAEs, and discontinuations due to AEs; however, the incidence of gastrointestinal AEs in OA patients treatment with celecoxib is significantly higher than that with placebo. For AE, the incidence of abdominal pain in OA patients with celecoxib was significantly higher than that with placebo (RR = 2.24, 95% CI: 1.40–3.58; P = 0.839, I2 = 0%). There was no significant difference in diarrhea, dyspepsia, headache, and nausea.

This meta-analysis indicated that celecoxib treatment (200 mg orally once daily) led to significant improvement in the pain and function of osteoarthritis. However, compared with placebo control, celecoxib resulted in greater gastrointestinal AEs, especially abdominal pain after approximately 10 to 13 weeks of treatment. The current study, therefore, provides valuable information to help physicians make treatment decisions for their patients with OA.

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