Document Detail


Efficacy and safety of rofecoxib in patients with chronic low back pain: results from two 4-week, randomized, placebo-controlled, parallel-group, double-blind trials.
MedLine Citation:
PMID:  12941996     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: Two replicate, 4-week, randomized, double-blind, placebo-controlled, trials of rofecoxib 25 and 50 mg versus placebo for chronic low back pain. OBJECTIVES: To determine the efficacy and safety of two doses of rofecoxib compared to placebo in the treatment of chronic low back pain. SUMMARY OF BACKGROUND DATA: Although nonsteroidal anti-inflammatory drugs are commonly prescribed for chronic low back pain, their efficacy is unproven and toxicity can be serious. These studies evaluated the efficacy and tolerability of rofecoxib, a selective COX-2 inhibitor, in the treatment of chronic low back pain. METHODS: Patients with chronic low back pain were randomized 1:1:1 to rofecoxib 25 mg, 50 mg, or placebo once daily. Primary endpoint: Low Back Pain Intensity. Secondary endpoints: Pain Bothersomeness, Global Assessments of Response to Therapy, Global Assessment of Disease Status, Roland-Morris Disability Questionnaire, SF-12 Health Survey, Use of Rescue Acetaminophen, and Discontinuations Due to Lack of Efficacy. RESULTS: Combining both studies, 690 patients were randomized to placebo (N = 228), rofecoxib 25 mg (N = 233), or rofecoxib 50 mg (N = 229). Mean (+/- SD) age was 53.4 (+/- 12.9) years, pain duration 12.1 (+/- 11.8) years, 62.3% female. Both rofecoxib groups improved significantly. Mean differences from placebo in pain intensity were -13.50 mm, -13.81 mm (25, 50 mg doses) respectively (P < 0.001). Both regimens were superior to placebo in eight of nine secondary endpoints. Fifty mg provided no advantage over 25 mg. Both rofecoxib regimens were well tolerated, although 25 mg had a slightly better safety profile. CONCLUSIONS: Rofecoxib significantly reduced chronic low back pain in adults and was well tolerated.
Authors:
Nathaniel Katz; William D Ju; David A Krupa; Rhoda S Sperling; Diana Bozalis Rodgers; Barry J Gertz; Joseph Gimbel; Spencer Coleman; Chester Fisher; Shahriar Nabizadeh; David Borenstein;
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Spine     Volume:  28     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-08-27     Completed Date:  2004-02-25     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  851-8; discussion 859     Citation Subset:  IM    
Affiliation:
Pain Trials Center, Brigham & Women's Hospital, Boston, Massachusetts, USA. NatPaulKatz@aol.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Anti-Inflammatory Agents, Non-Steroidal / adverse effects,  therapeutic use*
Chronic Disease
Cyclooxygenase Inhibitors / adverse effects,  therapeutic use*
Disability Evaluation
Dose-Response Relationship, Drug
Double-Blind Method
Female
Health Status
Humans
Lactones / adverse effects,  therapeutic use*
Low Back Pain / drug therapy*
Male
Middle Aged
Pain Measurement / drug effects
Questionnaires
Sulfones
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 0/Cyclooxygenase Inhibitors; 0/Lactones; 0/Sulfones; 0/rofecoxib

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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