Treatment of osteoarthritis with piroxicam

A large scale multicentre study was carried out in 757 patients with osteoarthritis in hospital clinics and general practice. It was intended to compare the efficacy and tolerance of piroxicam and placebo, and to compare morning administration of piroxicam with evening administration. Piroxicam in a single daily dose of 20 mg was shown to be superior to placebo. In the first two weeks of treatment the incidence of side-effects with piroxicam was similar to placebo. Piroxicam was equally effective when administered in the morning or at night, evidence for the view that a single daily dose relieves symptoms for at least 24 hours. There was a suggestion that the side-effects with piroxicam, particularly gastrointestinal were less frequent when the medication was taken at night. Responses were similar in hospital and general practice patients and in those under or over the age of 70. A good or fair response to piroxicam was achieved in 81% of patients. Sixty seven per cent reported piroxicam as better than their previous therapy, and the same percentage elected to continue treatment with the drug at the end of the study. About half of all side effects were thought to be drug related and about half were gastrointestinal. Side effects led to withdrawal of treatment in 8% of all patients receiving piroxicam. There were 5 cases of haematemesis or melaena (0.7%). There were 30 reports of oedema or weight gain an incidence of 4%. Side-effects of all types were similar in patients under and over the age of 70. This study confirms the efficacy and good toleration of piroxicam in the treatment of osteoarthritis predicted by earlier clinical trial experience.