Etoricoxib for pain management in a general practitioner’s office Review article
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Published:
Apr 9, 2025
Keywords:
etoricoxib, pain, osteoarthritis, rheumatoid arthritis
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Abstract
Etoricoxib – a selective cyclooxygenase 2 inhibitor – was introduced to therapy almost 20 years ago. It has proven to be an effective anti-inflammatory and analgesic drug for many chronic diseases of the musculoskeletal system, especially osteoarthritis and rheumatoid arthritis. The study includes the most important aspects of etoricoxib therapy, including indications, pharmacodynamics, pharmacokinetics and potentially new applications. The collected experience supported by the results of clinical studies should help to adapt the therapy of inflammatory pain to the individual needs of a specific patient. The ultimate goal of the study is to make etoricoxib therapy even more effective and even safer in the practice of a family doctor.
Article Details
How to Cite
Rupiński, R. (2025). Etoricoxib for pain management in a general practitioner’s office. Medycyna Faktow (J EBM), 18(1(66), 78-83. https://doi.org/10.24292/01.MF.0125.12
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References
1. Wikipedia. Etoricoxib.
2. Zacher J, Feldman D, Gerli R et al. A comparison of the therapeutic efficacy and tolerability of etoricoxib and diclofenac in patients with osteoarthritis. Curr Med Res Opin. 2003; 19: 725-36.
3. Leung AT, Malmstrom K, Gallacher AE et al. Efficacy and tolerability profile of etoricoxib in patients with osteoarthritis: a randomized, doubl-blind, placebo and active-comparator controlled 12-week efficacy trial. Curr Med Res Opin. 2002; 18: 49-58.
4. Bingham OC, Sebba AI, Rubin BR et al. Efficacy and safety of etoricoxib 30 mg and celecoxib 200 mg in the treatment of osteoarthritis in two identically designed, randomized, placebo-controlled, non-inferiority studies. Rheumatology. 2007; 46: 496-507.
5. Wiesenhutter CW, Boice JA, Ko A et al. Evaluation of the comparative efficacy of etoricoxib and ibuprofen for treatment of patients with osteoarthritis: a randomized, double-blind, placebo controlled trial. Mayo Clin Proc. 2005; 80: 470-9.
6. Bickham K, Kivitz AJ, Mehta A et al. Evaluation of two doses of etoricoxib, a COX-2 selective non-steroidal anti-inflammatory drug (NSAID), in the treatment of Rheumatoid Arthritis in a double-blind, randomized controlled trial. BMC Musculoskelet Disord. 2016; 17: 331. http://doi.org/10.1186/s12891-016-1170-0.
7. Ramiro S, Nikiphorou E, Sepriano A et al. ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update. Ann Rheum Dis. 2023; 82(1): 19-34.
8. Fan M, Liu J, Zhao B et al. Indirect comparison of NSAIDs for ankylosing spondylitis: Network meta‑analysis of randomized, double‑blinded, controlled trials. Exp Ther Med. 2020; 19: 3031-41.
9. van Durme CMPG, Wechalekar MD, Buchbinder R et al. Non-steroidal anti-inflammatory drugs for acute gout. Cochrane Database Syst Rev. 2014; 9: CD010120. http://doi.org/10.1002/14651858.
10. Clarke R, Derry S, Moore RA. Single dose oral etoricoxib for acute postoperative pain in adults. Cochrane Database Syst Rev. 2014; 2014(5): CD004309. http://doi.org/10.1002/14651858.
11. Lluch E, Torres R, Nijs J et al. Evidence for central sensitization in patients with osteoarthritis pain: a systematic literature review. Eur J Pain. 2014; 18(10): 1367e75.
12. Renner B, Zacher J, Buvanendran A et al. Absorption and distribution of etoricoxib in plasma, CSF, and wound tissue in patients following hip surgery – a pilot study. Schmiedeb Arch Pharmacol. 2010; 381: 127e36.
13. Moss P, Benson HAE, Will R et al. Fourteen days of etoricoxib 60 mg improves pain, hyperalgesia and physical function in individuals with knee osteoarthritis: a randomized controlled trial. Osteoarthritis Cartilage. 2017; 25(11): 1781-91.
14. Arendt-Nielsen L, Egsgaard LL, Petersen KK. Evidence for a central mode of action for etoricoxib (COX-2 inhibitor) in patients with painful knee osteoarthritis. Pain. 2016; 157(8): 1634-44.
15. Woroń J. Zastosowanie etorykoksybu w bólu zapalnym. Kiedy jest lekiem z wyboru? Lekarz POZ. 2023; 2: 99-104.
16. Nakata K, Hanai T, Take Y et al. Disease-modifying effects of COX-2 selective inhibitors and non-selective NSAIDs in osteoarthritis: a systematic review. Osteoarthritis Cartilage. 2018; 26: 1263-73.
17. https://indeks.mp.pl/leki/desc.php?id=18552 (dostęp 08.04.2025.).
18. Laine L, Curtis SP, Cryer B et al. Assessment of upper gastrointestinal safety of etoricoxib and diclofenac in patients with osteoarthritis and rheumatoid arthritis in the Multinational Etoricoxib and Diclofenac Arthritis Long-term (MEDAL) programme: a randomised comparison. Lancet. 2007; 369: 465-73.
19. Hunt RH, Harper S, Watson DJ et al. The gastrointestinal safety of the COX-2 selective inhibitor etoricoxib assessed by both endoscopy and analysis of upper gastrointestinal events. Am J Gastroenterol. 2003; 98: 1725-33.
20. Kwiatkowska B, Majdan M, Mastalerz-Migas A et al. Status of etoricoxib in the treatment of rheumatic diseases. Expert panel opinion. Reumatologia. 2017; 55(6): 290-7.
21. Walker Ch. Are All Oral COX-2 Selective Inhibitors the Same? A Consideration of Celecoxib, Etoricoxib, and Diclofenac. Int J Rheumatol. 2018; 2018: 1302835.
22. Jagannathan H, Thota A, Kumarappa AK et al. A comparative study of aceclofenac versus etoricoxib in the management of acute low back pain in a tertiary care hospital. J Drug Assess. 2020; 9(1): 60-5.
23. Birbara CA, Puopolo AD, Munoz DR et al. Treatment of chronic low back pain with etoricoxib, a new cyclo-oxygenase-2 selective inhibitor: improvement in pain and disability – a randomized, placebo-controlled, 3-month trial. J Pain. 2003; 4(6): 307-15.
24. Zerbini C, Ozturk ZE, Grifka J et al. Efficacy of etoricoxib 60 mg/day and diclofenac 150 mg/day in reduction of pain and disability in patients with chronic low back pain: results of a 4-week, multinational, randomized, double-blind study. Curr Med Res Opin. 2005; 21(12): 2037-49.
25. Karmakar A, Arora S, Singal R et al. The Efficacy and Safety of a Combination of Thiocolchicoside and Etoricoxib in Low Back Pain (ESCoTEL): A Randomized Active-Controlled Trial. Cureus. 2023; 15(10): e47621.
2. Zacher J, Feldman D, Gerli R et al. A comparison of the therapeutic efficacy and tolerability of etoricoxib and diclofenac in patients with osteoarthritis. Curr Med Res Opin. 2003; 19: 725-36.
3. Leung AT, Malmstrom K, Gallacher AE et al. Efficacy and tolerability profile of etoricoxib in patients with osteoarthritis: a randomized, doubl-blind, placebo and active-comparator controlled 12-week efficacy trial. Curr Med Res Opin. 2002; 18: 49-58.
4. Bingham OC, Sebba AI, Rubin BR et al. Efficacy and safety of etoricoxib 30 mg and celecoxib 200 mg in the treatment of osteoarthritis in two identically designed, randomized, placebo-controlled, non-inferiority studies. Rheumatology. 2007; 46: 496-507.
5. Wiesenhutter CW, Boice JA, Ko A et al. Evaluation of the comparative efficacy of etoricoxib and ibuprofen for treatment of patients with osteoarthritis: a randomized, double-blind, placebo controlled trial. Mayo Clin Proc. 2005; 80: 470-9.
6. Bickham K, Kivitz AJ, Mehta A et al. Evaluation of two doses of etoricoxib, a COX-2 selective non-steroidal anti-inflammatory drug (NSAID), in the treatment of Rheumatoid Arthritis in a double-blind, randomized controlled trial. BMC Musculoskelet Disord. 2016; 17: 331. http://doi.org/10.1186/s12891-016-1170-0.
7. Ramiro S, Nikiphorou E, Sepriano A et al. ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update. Ann Rheum Dis. 2023; 82(1): 19-34.
8. Fan M, Liu J, Zhao B et al. Indirect comparison of NSAIDs for ankylosing spondylitis: Network meta‑analysis of randomized, double‑blinded, controlled trials. Exp Ther Med. 2020; 19: 3031-41.
9. van Durme CMPG, Wechalekar MD, Buchbinder R et al. Non-steroidal anti-inflammatory drugs for acute gout. Cochrane Database Syst Rev. 2014; 9: CD010120. http://doi.org/10.1002/14651858.
10. Clarke R, Derry S, Moore RA. Single dose oral etoricoxib for acute postoperative pain in adults. Cochrane Database Syst Rev. 2014; 2014(5): CD004309. http://doi.org/10.1002/14651858.
11. Lluch E, Torres R, Nijs J et al. Evidence for central sensitization in patients with osteoarthritis pain: a systematic literature review. Eur J Pain. 2014; 18(10): 1367e75.
12. Renner B, Zacher J, Buvanendran A et al. Absorption and distribution of etoricoxib in plasma, CSF, and wound tissue in patients following hip surgery – a pilot study. Schmiedeb Arch Pharmacol. 2010; 381: 127e36.
13. Moss P, Benson HAE, Will R et al. Fourteen days of etoricoxib 60 mg improves pain, hyperalgesia and physical function in individuals with knee osteoarthritis: a randomized controlled trial. Osteoarthritis Cartilage. 2017; 25(11): 1781-91.
14. Arendt-Nielsen L, Egsgaard LL, Petersen KK. Evidence for a central mode of action for etoricoxib (COX-2 inhibitor) in patients with painful knee osteoarthritis. Pain. 2016; 157(8): 1634-44.
15. Woroń J. Zastosowanie etorykoksybu w bólu zapalnym. Kiedy jest lekiem z wyboru? Lekarz POZ. 2023; 2: 99-104.
16. Nakata K, Hanai T, Take Y et al. Disease-modifying effects of COX-2 selective inhibitors and non-selective NSAIDs in osteoarthritis: a systematic review. Osteoarthritis Cartilage. 2018; 26: 1263-73.
17. https://indeks.mp.pl/leki/desc.php?id=18552 (dostęp 08.04.2025.).
18. Laine L, Curtis SP, Cryer B et al. Assessment of upper gastrointestinal safety of etoricoxib and diclofenac in patients with osteoarthritis and rheumatoid arthritis in the Multinational Etoricoxib and Diclofenac Arthritis Long-term (MEDAL) programme: a randomised comparison. Lancet. 2007; 369: 465-73.
19. Hunt RH, Harper S, Watson DJ et al. The gastrointestinal safety of the COX-2 selective inhibitor etoricoxib assessed by both endoscopy and analysis of upper gastrointestinal events. Am J Gastroenterol. 2003; 98: 1725-33.
20. Kwiatkowska B, Majdan M, Mastalerz-Migas A et al. Status of etoricoxib in the treatment of rheumatic diseases. Expert panel opinion. Reumatologia. 2017; 55(6): 290-7.
21. Walker Ch. Are All Oral COX-2 Selective Inhibitors the Same? A Consideration of Celecoxib, Etoricoxib, and Diclofenac. Int J Rheumatol. 2018; 2018: 1302835.
22. Jagannathan H, Thota A, Kumarappa AK et al. A comparative study of aceclofenac versus etoricoxib in the management of acute low back pain in a tertiary care hospital. J Drug Assess. 2020; 9(1): 60-5.
23. Birbara CA, Puopolo AD, Munoz DR et al. Treatment of chronic low back pain with etoricoxib, a new cyclo-oxygenase-2 selective inhibitor: improvement in pain and disability – a randomized, placebo-controlled, 3-month trial. J Pain. 2003; 4(6): 307-15.
24. Zerbini C, Ozturk ZE, Grifka J et al. Efficacy of etoricoxib 60 mg/day and diclofenac 150 mg/day in reduction of pain and disability in patients with chronic low back pain: results of a 4-week, multinational, randomized, double-blind study. Curr Med Res Opin. 2005; 21(12): 2037-49.
25. Karmakar A, Arora S, Singal R et al. The Efficacy and Safety of a Combination of Thiocolchicoside and Etoricoxib in Low Back Pain (ESCoTEL): A Randomized Active-Controlled Trial. Cureus. 2023; 15(10): e47621.