DOUBLE-BLIND COMPARATIVE-STUDY OF ETODOLAC AND PIROXICAM IN PATIENTS WITH OSTEOARTHRITIS OF THE KNEE

The efficacy and safety of etodolac 300 mg twice daily and piroxicam 20 mg once daily were compared in this 6-week, double-blind, randomized, parallel-group study in 57 outpatients with osteoarthritis (OA) of the knee. Evaluations were made at baseline and at weeks 2, 4, and 6 for primary (patient's and physician's overall evaluation, pain intensity, and night pain) and secondary (pain on standing, pain on walking, pain getting in and out of bed, pain getting up from a chair, pain on climbing stairs, tenderness, swelling, erythema, knee flexion, time to walk 50 feet, and morning stiffness) efficacy assessments. Etodolac more consistently produced significant improvement in the duration of morning stiffness throughout treatment and tended to produce greater improvement in mean pain scores. In addition, a higher percentage of etodolac-treated patients than piroxicam-treated patients had improvement in weight-bearing assessments at the final evaluation. Etodolac patients had a 53% improvement in morning stiffness duration at the final evaluation versus 9% for piroxicam patients; night pain improved 23% versus 16%; and pain on standing improved 23% versus 19%. Piroxicam more consistently resulted in improvement in some measures of inflammation and mobility. Improvement in tenderness on pressure improved 12% for etodolac and 23% for piroxicam, and knee flexion improved 4% for etodolac and 9% for piroxicam. Treatment-related adverse events were reported for 15 patients in each group; the most frequent involved the gastrointestinal system for both groups. There was one episode of melena in the piroxicam group, but no evidence of gastro-intestinal bleeding in the etodolac group. The results indicate that etodolac is well tolerated and is as efficacious as piroxicam for the treatment of patients with OA of the knee.