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Single dose oral rofecoxib for postoperative pain
J Barden1, J Edwards, R A Moore
1Pain Research Unit, University of Oxford, Churchill Hospital, Old Road, Oxford, UK, OX3 7LJ. jodie.barden@pru.ox.ac.uk
The Cochrane Database of Systematic Reviews
|January 28, 2005
Summary
Rofecoxib (Vioxx) effectively relieved postoperative pain, with a number-needed-to-treat of 2.2. This selective COX-2 inhibitor showed fewer adverse events compared to placebo in short-term studies.
Area of Science:
- Pharmacology
- Pain Management
- Clinical Trials
Background:
- Rofecoxib (Vioxx) is a selective cyclooxygenase-2 (COX-2) inhibitor.
- It was used for acute pain and had fewer gastrointestinal issues than NSAIDs.
- Concerns about heart attack and stroke risk led to its market withdrawal in 2004.
Purpose of the Study:
- To evaluate the analgesic efficacy of a single oral dose of rofecoxib.
- To assess adverse effects of rofecoxib for moderate to severe postoperative pain.
- To compare rofecoxib's effectiveness against other acute pain analgesics.
Main Methods:
- Searched multiple databases including Cochrane Library, MEDLINE, and PubMed.
- Included randomized controlled trials of adult patients receiving rofecoxib or placebo for postoperative pain.
- Extracted data on pain relief, calculating relative benefit and number-needed-to-treat (NNT).
Main Results:
- Seven studies involving 667 patients on rofecoxib 50 mg and 315 on placebo met criteria.
- The NNT for rofecoxib 50 mg was 2.2 (95% CI 1.9 to 2.4).
- Adverse events were less frequent with rofecoxib 50 mg compared to placebo.
Conclusions:
- Rofecoxib 50 mg is an effective single oral dose for acute postoperative pain.
- The dose used was 2-4 times the standard daily dose for chronic pain.
- Short-term studies indicated favorable efficacy and safety profile.