J Korean Rheum Assoc.  2002 Dec;9(4):267-277.

The Comparison of the Efficacy and Adverse Drug Reaction ofCelecoxib and Diclofenac in the Treatment of Osteoarthritis in Korean Multicenter Trial

• Ahn HJ
• Lee CH
• Chung SM
• Lee SH
• Lee CK
• Bae SK
• Song JS
• Park W
• Bae SC
• Yoo DH
• Lee YW

Abstract

OBJECTIVE
Long-term use of the analgesic acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of osteoarthritis is limited due to the lack of effectiveness and presence of side effects. Celecoxib is a selective inhibitor of cyclo-oxygenase (COX)-2 and expected to help NSAIDs in expressing the effective anti-inflammatory effect by not inhibiting COX-1. Thus, 200 mg of celecoxib and 100 mg of slow releasing diclofenac were compared for their effectiveness and safety in Korean patients with knee osteoarthritis.
METHODS
We administered 200 mg of celecoxib or 100 mg of slow releasing diclofenac in 223 randomly selected patients with knee osteoarthritis for 4 weeks. The effectiveness of these drugs on osteoarthritis was assessed by evaluating pain in each patient, making overall evaluation on osteoarthritis by the patient and his/her attending physician, and measuring the severity indices on osteoarthritis before treatment, and 2 weeks and 4 weeks after treatment. Moreover, safety and drug resistance were evaluated by assessing the rate of adverse effects, rate of withdrawal, laboratory tests, and vital signs.
RESULTS
The clinical symptoms of osteoarthritis were improved significantly by 4 weeks after treatment with celecoxib and diclofenac. According to the results of overall evaluation made by attending physicians 2 weeks after treatment, the rate of improvement was 49.5% in celecoxib group and 35.7% in diclofenac group, showing a statistically significant difference (p=0.023). Other than this difference, no other significant difference was present between the two groups with other variables used for the evaluation of effectiveness. The rate of adverse effects was significantly lower in celecoxib group compared with diclofenac group. According to laboratory findings, no abnormal figure was found in both groups but total bilirubin, SGOT, and SGPT were consistently higher in patients in diclofenac group. Thirteen patients dropped out of the study due to side effects (10 patients) and treatment failure (3 patients).
CONCLUSION
Our findings from the clinical comparison of celecoxib and diclofenac in Korean patients with knee osteoarthritis were similar to those results found in previous studies. Although celecoxib showed similar effectiveness as diclofenac on knee osteoarthritis in the treatment of symptoms, it showed a lower rate of adverse effects; thus, we concluded that celecoxib is safer compared with diclofenac.

Keyword

Osteoarthritis; Celecoxib; Diclofenac; Efficacy; Adverse drug reaction

MeSH Terms

Acetaminophen
Alanine Transaminase
Anti-Inflammatory Agents, Non-Steroidal
Aspartate Aminotransferases
Bilirubin
Diclofenac*
Drug Resistance
Drug-Related Side Effects and Adverse Reactions*
Humans
Osteoarthritis*
Osteoarthritis, Knee
Prostaglandin-Endoperoxide Synthases
Treatment Failure
Vital Signs
Acetaminophen
Alanine Transaminase
Anti-Inflammatory Agents, Non-Steroidal
Aspartate Aminotransferases
Bilirubin
Diclofenac
Prostaglandin-Endoperoxide Synthases
Celecoxib