Preemptive versus postoperative lumiracoxib for analgesia in ambulatory arthroscopic knee surgery

Original Research

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Authors: Joachim Grifka, Rudolf Enz, Joachim Zink, Jean Louis Hugot, Andreas Kreiss, et al

Published Date November 2008 Volume 2008:1 Pages 27 - 34

DOI: http://dx.doi.org/10.2147/JPR.S3928

Joachim Grifka¹, Rudolf Enz², Joachim Zink³, Jean Louis Hugot⁴, Andreas Kreiss⁵, Udayasankar Arulmani⁴, Vincent Yu⁶, Rosemary Rebuli⁴, Gerhard Krammer⁴

¹Orthopädische Klinik der Univ, Regensburg, Germany; ²DiaMed Centrum, Klinik Neuendettelsau, Neuendettelsau, Germany; ³Orthopädische Fachpraxisgemeinschaft, Jena Zwätzen, Deutschland, Germany; ⁴Novartis Pharma AG, Basel, Switzerland; ⁵Novartis Pharma GmbH, Nürnberg, Germany; ⁶Novartis Pharma AG, East Hanover, NJ, USA

Abstract: We compared the efficacy and safety of preemptive vs postoperative dosing of lumiracoxib 400 mg in patients undergoing minor ambulatory arthroscopic knee surgery. Eligible patients were randomized to preemptive lumiracoxib, postoperative lumiracoxib, and placebo. The main efficacy parameter was pain intensity (PI) (0–100 mm visual analog scale) in the target knee upon movement, 2 hours after surgery. Other efficacy variables included PI in the target knee at rest and upon movement at 1, 3, 4, and 24 hours, time to first rescue medication intake. In the lumiracoxib preemptive and postoperative groups, the estimated treatment difference compared to placebo for primary endpoint was –4.0 (95% CI: –9, –1; p = 0.007) and –3.5 (95% CI: –8.5, 0; p = 0.052), respectively. There was no statistical significant difference between two active treatment groups (p = 0.602). Both preemptive and postoperative lumiracoxib resulted in significantly lower PI scores at rest and after movement at all time-points and no statistically significant difference was observed between the active treatments. Time to rescue medication intake was comparable for both active treatments. The proportion of adverse events was similar among all groups. We conclude that the efficacy of lumiracoxib 400 mg is not affected by the timing of administration (preemptive or postoperative).

Keywords: arthroscopy, arthroscopic knee surgery, lumiracoxib, NSAIDs, postoperative pain, preemptive dosing