Date of Award

2013

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department Chair

John Cavenagh, PhD, PA-C

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Valdecoxib is an effective treatment option to improve pain in adults with osteoarthritis of the hip or knee.

STUDY DESIGN: This review consists of three randomized control trials; two were published in 2002 and the third in 2006.

DATA SOURCES: Sources were studies comparing groups taking Valdecoxib 10mg QD to placebo, which were found via Pubmed, MEDLINE, Ovid, and Cochrane databases.

OUTCOMES MEASURED: The three articles measured various outcomes: pain improvement, stiffness, physical improvement, adverse effects, and onset of analgesia during acute pain flare. Outcomes were measured via the Patient’s Assessment of Arthritis Pain- Visual Analog Scale (PAAP-VAS), WOMAC osteoarthritis, Patient’s (PaGAA) and Physician’s (PhGAA) Global Assessment of Arthritis.

RESULTS: Kivitz et al found that Valdecoxib 10mg & 20mg daily doses were similar in efficacy and both were superior to placebo. Valdecoxib 5mg was not found to be superior to placebo.5 Makarowski et al also found that Valdecoxib 5mg and 10mg QD were superior to placebo. They also found that Valdecoxib 10mg QD was superior in efficacy to Valdecoxib 5mg QD.6 Moskowitz et al found that patients had both a significant improvement in pain at 3 hours with Valdecoxib as compared to placebo, and a statistically significant increase in percentage of patients with analgesia after 4hrs compared to placebo.7

CONCLUSION: These three randomized control trials all concluded that Valdecoxib is superior to placebo in doses of at least 10mg as compared to placebo. Further studies should review safety of Valdecoxib in a risk/benefit analysis to provide useful conclusions about the continued use of it for treatment of osteoarthritis.

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