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Area of Science:

  • Rheumatology
  • Pharmacology
  • Clinical Trials

Background:

  • Osteoarthritis (OA) is a prevalent degenerative joint disease causing significant disability.
  • Current OA treatment lacks consensus on optimal symptom management.
  • Celecoxib is a selective non-steroidal anti-inflammatory drug (NSAID).

Purpose of the Study:

  • To evaluate the clinical benefits of celecoxib in OA, focusing on pain, function, and quality of life.
  • To assess the safety profile of celecoxib, including adverse events and discontinuation rates.
  • To compare celecoxib against placebo and traditional NSAIDs (tNSAIDs) in OA management.

Main Methods:

  • Systematic review and meta-analysis of prospective randomized controlled trials (RCTs).
  • Searched multiple databases (CENTRAL, MEDLINE, Embase) and clinical trial registers up to April 2017.
  • Included 36 RCTs with 17,206 adult participants comparing celecoxib with placebo or tNSAIDs.

Main Results:

  • Celecoxib showed slight, potentially non-clinically significant, improvements in pain and physical function compared to placebo.
  • Evidence was inconclusive regarding differences in adverse events (AEs), serious AEs (SAEs), gastro-intestinal, and cardiovascular events between celecoxib and placebo.
  • Results for comparisons between celecoxib and tNSAIDs were largely inconclusive due to low-quality evidence and data limitations.

Conclusions:

  • Current evidence suggests marginal benefits of celecoxib over placebo and some tNSAIDs for OA pain and function.
  • Significant uncertainty exists regarding celecoxib's safety profile compared to placebo and tNSAIDs due to bias and limited data.
  • Further independent clinical trials with longer follow-up are essential to clarify the benefits and harms of celecoxib in OA.