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Osteoarthritis
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my personal edition > osteoarthritis > news
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DGReview
Etodolac SR Causes Fewer Side Effects than Diclofenac in Knee Osteoarthritis
A DGReview of :"Double-blind, randomised, comparative trial of etodolac SR versus diclofenac in the treatment of osteoarthritis of the knee"
Current Medical Research and Opinion
07/22/2003
By Emma Hitt, PhD
For the treatment of osteoarthritis of the knee, etodolac sustained release (SR) is as effective as diclofenac and appears to cause fewer side effects, according to the findings of a double-blind randomised trial.
The new nonsteroidal anti-inflammatory drug (NSAID) etodolac has previously been shown to be at least as effective as other NSAIDs, such as aspirin, indomethacin and piroxicam.
T.H. Liang, MD, with Taipei Medical University, Taiwan, and colleagues compared the efficacy and safety of etodolac SR with that of diclofenac, also an NSAID used for the treatment of osteoarthritis, which has been commercially available since 1974.
A total of 64 patients with osteoarthritis of the knee received either once-daily etodolac SR 400 mg/day or twice-daily diclofenac 100 mg/day for 4 weeks. Patients were assessed for efficacy and adverse effects 2 and 4 weeks after the baseline visit.
The two drugs produced comparable pain relief as measured by a 10-cm visual analogue scale (P=0.0002 for etodolac SR, P=0.0008 for diclofenac). Likewise, the degree of functional impairment and the amount of paracetamol needed for pain relief were similar between groups.
In contrast, the etodolac SR treatment group had fewer incidents of adverse event, with 40.6% of the etodolac SR group reporting at least one adverse event compared with 84.4% of diclofenac-treated patients.
In addition, 82.1% of etodolac SR-treated patients rated their tolerability as "very good" and "good", whereas only 56.7% of diclofenac-treated patients responded similarly.
The etodolac SR-treated group also took fewer antacids and reported fewer gastrointestinal symptoms than the diclofenac-treated group.
Dr. Liang and colleagues conclude that etodolac SR is as effective as diclofenac in the treatment of osteoarthritis of the knee, adding, "Etodolac SR is superior to diclofenac in respect of safety, such as GI symptoms and impact on liver function."
"Considering that three diclofenac-treated patients showed aggravation in their serum glutamate pyruvate transaminase levels in the present study, possible adverse effects on liver function should be addressed for diclofenac," they caution.
Curr Med Res Opin 2003;19:336-341.
"Double-blind, randomised, comparative trial of etodolac SR versus diclofenac in the treatment of osteoarthritis of the knee"
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