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Meta-Analysis
. 2010 Jul 7;2010(7):CD006865.
doi: 10.1002/14651858.CD006865.pub2.

Single dose oral lumiracoxib for postoperative pain in adults

Yvonne M Roy  1 , Sheena Derry, R Andrew Moore
Affiliations
Meta-Analysis

Single dose oral lumiracoxib for postoperative pain in adults

Yvonne M Roy et al. Cochrane Database Syst Rev. .

Abstract

Background: Lumiracoxib is a selective cyclooxygenase-2 (COX-2) inhibitor. COX-2 inhibitors were developed to avoid COX-1-related gastrointestinal (GI) problems while maintaining the analgesic and anti-inflammatory activity of traditional non-steriodal anti-inflammatory drugs (NSAIDs).

Objectives: To review the analgesic efficacy, duration of analgesia, and adverse effects of a single oral dose of lumiracoxib for moderate to severe postoperative pain in adults.

Search strategy: We searched Cochrane CENTRAL, MEDLINE, and EMBASE to February 2010.

Selection criteria: Single oral dose, randomised, double-blind, placebo-controlled trials of lumiracoxib for relief of established moderate to severe postoperative pain in adults.

Data collection and analysis: Studies were assessed for methodological quality and the data extracted by two review authors independently. Summed total pain relief over six hours (TOTPAR 6) was used to calculate the number of participants achieving at least 50% pain relief. These derived results were used to calculate, with 95% confidence intervals, the relative benefit compared to placebo, and the number needed to treat (NNT) for one participant to experience at least 50% pain relief over six hours. Numbers of participants using rescue medication, and time to use of rescue medication, were sought as additional measures of efficacy. Information on adverse events and withdrawals was collected.

Main results: In this updated review four studies met the inclusion criteria. In total 366 participants were treated with lumiracoxib 400 mg, 51 with lumiracoxib 100 mg, and 212 with placebo. Active comparators were naproxen 500 mg, rofecoxib 50 mg, celecoxib 200 mg, celecoxib 400 mg, and ibuprofen 400 mg. With lumiracoxib 400 mg 50% of participants had at least 50% pain relief over six hours, compared with 8% given placebo; RB 6.9 (95% CI 4.1 to 12), NNT 2.4 (2.1 to 2.8).Median time to onset of analgesia was shorter for lumiracoxib 400 mg (0.6 to 1.5 hours) than placebo (>12 hours). Fewer participants needed rescue medication with lumiracoxib (64%) than with placebo (91%) over 12 to 24 hours; NNT to prevent remedication 3.7 (2.9 to 5.0). The weighted median time to use of rescue medication was 9.4 hours for lumiracoxib 400 mg and 1.7 hours for placebo.Adverse events were generally mild to moderate in severity, with one serious event reported in a placebo patient.

Authors' conclusions: Lumiracoxib 400 mg given as a single oral dose is an effective analgesic for acute postoperative pain, and has a relatively long duration of action. Adverse events with lumiracoxib did not differ from placebo.

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Conflict of interest statement

SD and RAM have received research support from charities, government and industry sources at various times, but no such support was received for this work. RAM and HJM have consulted for various pharmaceutical companies. RAM has received lecture fees from pharmaceutical companies related to analgesics and other healthcare interventions. YMR is employed by the PaPaS Review Group.

Figures

1
1
Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
2
2
Forest plot of comparison: 1 Lumiracoxib versus placebo, outcome: 1.1 Participants with at least 50% pain relief at 6 hours.
3
3
L'Abbé plot of the four trials, with proportion achieving at least 50% pain relief over six hours with lumiracoxib 400 mg and placebo. The size of the symbol is proportional to the size of the study. Yellow = dental studies, pink = orthopaedic study
1.1
1.1. Analysis
Comparison 1 Lumiracoxib versus placebo, Outcome 1 Participants with at least 50% pain relief at 6 hours.
1.2
1.2. Analysis
Comparison 1 Lumiracoxib versus placebo, Outcome 2 Participants using rescue medication.
1.3
1.3. Analysis
Comparison 1 Lumiracoxib versus placebo, Outcome 3 Participants with at least one adverse event.
See this image and copyright information in PMC

Update of

References

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