COX-2 Inhibitors Provide Additional Analgesia for RA Patients on DMARDs/Corticosteroids

COX-2 Inhibitors Provide Additional Analgesia for RA Patients on DMARDs/Corticosteroids

pillsResearchers in Norway determined that patients with rheumatic arthritis who receive corticosteroids and biological disease-modifying drugs still require concomitant analgesics to treat pain. The study titled “Do COX-2 inhibitors provide additional pain relief and anti-inflammatory effects in patients with rheumatoid arthritis who are on biological disease-modifying anti-rheumatic drugs and/or corticosteroids? Post-hoc analyses from a randomized clinical trial with etoricoxib,” was published in the journal BMC Musculoskeletal Disorders.

A majority of patients with rheumatoid arthritis (RA) list pain as a priority for improvement. Advances in therapeutics (i.e., corticosteroids [CS], synthetic disease-modifying antirheumatic drugs (sDMARDs), and biological DMARDs (bDMARDs) have demonstrated efficacy in reducing inflammation and controlling joint damage in patients with RA. However, recent research has suggested that RA patients can continue to experience significant levels of pain even when underlying disease markers of RA (i.e. DAS-28) are controlled by modern therapeutic regimens.

The research team led by Tore Kvien from the Department of Rheumatology, Diakonhjemmet Hospital in Norway and colleagues aimed to determine the effect of background biological disease-modifying antirheumatic drugs (bDMARDs) and/or corticosteroids (CS) on response to nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with rheumatoid arthritis (RA).

The research team evaluated Patient Global Assessment of Pain, Swollen Joint Count, Tender Joint Count, Health Assessment Questionnaire at baseline, and after 12 weeks in patients that received etoricoxib. The other three treatment groups were assessed for placebo, pooled etoricoxib 10/30/60 mg, and etoricoxib 90 mg.

Results showed that of the 1,014 patients screened, 761 were randomized in four groups: the first group had background bDMARDs and/or CS therapy (50%), the second group (23%) used bDMARDs, the third group (34%) used CS, and the fourth group (8%) used both bDMARDs and CS.

Based on these findings, the researchers determined that patients with rheumatoid arthritis that are treated with bDMARDs or CS have pain levels comparable to the pain levels at screening as patients without this co-medication. These results support that patients with rheumatoid arthritis under bDMARDs or CS might benefit from adjuvant analgesics to treat pain.

In other news on rheumatoid arthritis, Amgen has announced encouraging results from a Phase 3 study designed to assess its biosimilar candidate ABP 501 in patients who suffer from moderate to severe rheumatoid arthritis. The research was designed to evaluate the efficacy and safety of the drug in comparison with commonly-prescribed Humira (adalimumab), consistent with its primary and key secondary endpoints.


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