Valdecoxib Is More Efficacious Than Rofecoxib in Relieving Pain Associated With Oral Surgery

Abstract

Inhibition of the cyclooxygenase (COX)-2 enzyme has been shown previously to reduce pain and inflammation. Valdecoxib is a new highly selective COX-2 inhibitor with a rapid onset of action and significant analgesic properties. This study compared the analgesic efficacy of valdecoxib and rofecoxib in treating postoperative pain in patients undergoing oral surgery. This randomized, double-blind, placebo-controlled study compared the efficacy of 40 mg valdecoxib with that of 50 mg rofecoxib and placebo. Efficacy was assessed by the onset of analgesia, pain intensity levels, and pain relief over 24 hours, time-weighted sum of total pain, sum of pain intensity difference, the percentage of patients requiring rescue medication and experiencing regimen failure, and patients' global evaluation. Patients receiving valdecoxib experienced a significantly quicker onset of analgesia, significantly improved pain relief, and lower pain intensity compared with patients receiving rofecoxib and greater satisfaction with their study medication after a single dose. Valdecoxib also demonstrated efficacy that was superior to that of rofecoxib with respect to the percentage of patients requiring rescue medication or experiencing regimen failure (p < or =.05). Valdecoxib, rofecoxib, and placebo were equally well tolerated. This study demonstrates that valdecoxib provides significantly greater analgesic efficacy than rofecoxib in the management of pain after oral surgery.

The selective and non-selective cyclooxygenase inhibitors valdecoxib and piroxicam induce the same postoperative analgesia and control of trismus and swelling after lower third molar removal

“…The percentage of patients taking rescue medication was also very similar to that reported in another study assessing the clinical efficacy of valdecoxib, that is, about 32% (27). These results confirm the analgesic efficacy of piroxicam and valdecoxib after lower third molar removal (13,(20)(21)(22)(23)(24)(25)(26)(27)(28)(29).…”

“…Valdecoxib has been assessed in clinical studies of analgesic efficacy after third molar removal (13,(25)(26)(27)(28)(29)(30). However, none of these studies used the surgical model employed in ours.…”

“…In other studies, all patients had undergone surgical extraction of 2 or more impacted third molars, one of which was mandibular (13,29,30). Finally, other studies (25,28) assessed patients requiring the removal of three or more third molars, of which at least two were impacted, and at least one was an impacted mandibular molar. Therefore, the lack of uniformity of the methodology employed in these studies impairs the comparison of our results with others.…”

“…In contrast, there are only seven reports in the dental literature concerning the clinical use of valdecoxib, a COX-2 selective inhibitor, for postoperative pain control in patients who undergo dental surgeries (13,(25)(26)(27)(28)(29)(30). In these studies, either different doses of valdecoxib or its injectable prodrug parecoxib were tested (9,16,17,19) or a comparison with rofecoxib, another COX-2 selective inhibitor, was performed (25,28,30).…”

The pharmacological properties and clinical use of valdecoxib, a new cyclo‐oxygenase‐2‐selective inhibitor

“…24 The efficacy of a single dose of 40 mg valdecoxib has been compared with 50 mg rofecoxib and placebo in a randomized, double-blind, placebo-controlled clinical trial in 203 patients with moderate to severe pain following the extraction of two or more third molars with bone removal. 25 After surgery, patients received a single dose of 40 mg valdecoxib (n ¼ 80), 50 mg rofecoxib (n ¼ 82) or placebo (n ¼ 41). Analgesia was assessed over 24 h following surgery, and rescue medication was available on request.…”