Celecoxib better than diclofenac sodium for knee osteoarthritis

Patients with knee osteoarthritis may experience better pain relief with celecoxib than with diclofenac sodium, in addition to having lower levels of inflammatory markers and complication risk, a study has found.

Researchers performed a systematic review and meta-analysis of 12 trials comparing the efficacy of the two painkillers in terms of knee pain, C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), visual analogue scale (VAS) score, and complication rate.

There were 2,350 individuals included in the studies, with 1,189 in the celecoxib group and 1,161 in the diclofenac sodium group. Pooled data showed that treatment efficacy (rate graded as follows: clinically controlled, significantly improved, improved, or ineffective) was substantially greater with celecoxib (odds ratio [OR], 3.40, 95 percent confidence interval [CI], 2.17–5.32; p≤0.001), with good statistical homogeneity among the studies (I², 17.3 percent).

In terms of pain (assessed using the VAS score), celecoxib likewise proved more effective than diclofenac sodium (standardized mean difference [SMD], −1.44, 95 percent CI, −2.27 to −0.60; p≤0.001), with high heterogeneity.

Celecoxib also showed superiority to the other drug with respect to reducing CRP (SMD, −9.73, 95 percent CI, −15.75 to −3.72; p=0.002) and ESR (SMD, 5.56, 95 percent CI, 2.05–9.06; p=0.002), and the incidence of complications (OR, 0.34, 95 percent CI, 0.20–0.59; p≤0.001).

The findings suggest that celecoxib may favourably impact treatment of knee osteoarthritis by reducing pain, inflammatory markers and incidence of complications. Nevertheless, well-designed and high-quality trials are still needed.