Nationwide Etoricoxib Injection Clinical Experience (NICE) 2.0: Assessing Real-World Effectiveness and Tolerability...

Effective acute pain management remains a challenge. Etoricoxib, a selective COX-2 inhibitor, is known for its favorable safety profile compared to traditional NSAIDs. While oral etoricoxib is well-established for pain management, the intramuscular (IM) formulation remains underrepresented in the published literature and warrants further clinical investigation.

This study aims to assess the effectiveness of IM etoricoxib (90 mg/mL) in reducing acute pain severity in inpatient and outpatient settings and to evaluate its tolerability.

In this retrospective, multicenter, observational cohort study, medical records of 1,018 patients treated at the discretion of doctors across 296 centers in India were reviewed. Pain was assessed on the 10-point Visual Analog Scale (VAS). In outpatient settings, VAS score recordings were taken at baseline and at 30- and 60-minute post-injection intervals. In inpatient settings, recordings were taken at baseline, 30 minutes, 60 minutes, 6 hours, 12 hours, and 24 hours. Adverse events were documented.

The study included 1,018 patients, 229 (22.5%) inpatients and 789 (77.5%) outpatients. The primary indication for IM etoricoxib injection was acute back pain (272, 26.7%). Pain reduction, measured via VAS, showed significant results. In outpatients, VAS scores reduced by 61.6% at 60 minutes post-injection (p < 0.001). In inpatients, pain reduction was sustained over 24 hours, with a cumulative reduction of 69.45% at 24 hours (p < 0.001). The need for rescue analgesics was minimal (2.9%). Safety analysis revealed no adverse events in 992 (97.4%) of patients, with mild pain at the injection site in 338 (33.2%).

IM etoricoxib demonstrated rapid and sustained pain relief with excellent tolerability across diverse patient populations.