Methods 1082 patients meeting entry criteria for OA, responsive to NSAIDs, were randomised 3:3:1 to treatment with rofecoxib 25 mg qd (n = 471), celecoxib 200 mg qd (n = 460) or placebo (n = 151). Efficacy was assessed over the first 6 days of therapy and at weeks 2, 4, and 6 by WOMAC questionnaire and patient global assessment of response to therapy (PGART). Results Demographics were well balanced. Significantly more patients on placebo discontinued prematurely compared to both active groups (p < 0.001) mainly due to lack of efficacy. Rofecoxib provided statistically superior relief of night pain (p = 0.023), morning stiffness (p = 0.002), rest pain (p = 0.023), and walking pain (p = 0.005) compared to celecoxib. Rofecoxib was significantly superior to celecoxib on all WOMAC subsacles, including pain (p = 0.008), stiffness (p = 0.001) and physical function (p = 0.01). Rofecoxib was superior to celecoxib in % of patients with good or excellent PGART over 6 weeks (p = 0.014) and provided quicker onset of efficacy as assessed by time to first report of good or excellent response (p < 0.001). Both active groups were superior to placebo on efficacy endpoints. Incidence of clinical AEs, drug related AEs, serious AEs, and discontinuations due to AEs was similar between active groups. Conclusion In this study, once daily doses of rofecoxib provided superior relief of pain and other related symptoms in OA compared to celecoxib and placebo. All treatments were generally well tolerated.
Methods Rheumatologists from seven hospitals completed an audit form on consecutive patients in rheumatology outpatient departments over six months. Information on details of all orthopaedic procedures, waiting times, inpatient stays, complications, concurrent rheumatological drug therapies was obtained from medical records and from patients themselves (inflammatory joint disease was primary diagnosis in 81%). Results A total of 406 orthopaedic operations were performed in 293 patients, 106 total knee replacements (26%), 71 total hip replacements (17.5%), 48 wrist/hand joint operations (12%), 27 forefoot arthroplasties (6.7%), 15 shoulder replacements (3.7%), 14 elbow replacements (3.4%), 12 ankle fusions (3%) and the remainder miscellaneous.The main post operative complications which resulted in increased lenght of inpatient stay were wound sepsis (17), chest infection (4), deep vein thrombosis (4) joint dislocation/fracture (3). Main second line drugs were sulphasalzine (65) and methotrexate ( 58) and steroids were used by 39 patients. Figures will show differences between centres for waiting times (median 9 months) and inpatient stays (median 7 days). Conclusion Marked variations in waiting times could be identified to specific local difficulties which are being addressed. Cessation or changes in second line drugs were uncommon and created only short lasting problems, but need to be reviewed regularly.
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