Etoricoxib in the treatment of rheumatoid arthritis and osteoarthritis. Where does the role of the primary care physician end? Review article
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Published:
May 31, 2026
Keywords:
rheumatoid arthritis, osteoarthritis, pain, etoricoxib
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Abstract
Rheumatoid arthritis is a systemic connective tissue disease that can lead to irreversible joint damage. In pharmacotherapy, we use disease-modifying antirheumatic drugs, glicocorticosteroids, and, if necessary, analgesics, including nonsteroidal anti-inflammatory drugs. In osteoarthritis, there is no effective causal pharmacotherapy; treatment is based on medications that alleviate the patient’s symptoms. In both cases, etoricoxib remains a therapeutic option as a selective cyclooxygenase 2 inhibitor that exhibits fewer gastrointestinal and hepatic side effects compared to classic nonsteroidal anti-inflammatory drugs.
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How to Cite
Sapilak, B. J. (2026). Etoricoxib in the treatment of rheumatoid arthritis and osteoarthritis. Where does the role of the primary care physician end?. Medycyna Faktow (J EBM), 19(1(70), 47-52. https://doi.org/10.24292/01.MF.0126.6
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References
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9. Kvien TK, Greenwald M, Peloso PM et al. Do COX-2 inhibitors provide additional pain relief and anti-inflammatory effects in patients with rheumatoid arthritis who are on biological disease-modifying anti-rheumatic drugs and/or corticosteroids? Post-hoc analyses from a randomized clinical trial with etoricoxib. BMC Musculoskelet Disord. 2015; 16: 26.
10. 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 Musculosklet Disord. 2016; 17: 331-42.
11. Krueger K, Lino L, Dore R et al. Gastrointestinal tolerability of etoricoxib in rheumatoid arthritis patients: results of the etoricoxib vs diclofenac sodium gastrointestinal tolerability and effectiveness trial (EDGE-II). Ann Rheum Dis. 2008; 67: 315-22.
12. 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.
13. Chen AI, Lee YH, Perng WT et al. Celecoxib and Etoricoxib may reduce risk of ischemic stroke in patients with rheumatoid arthritis: A nationwide retrospective cohort study. Front Neurol. 2022; 13: 1018521.
14. Puopolo A, Boice JA, Fidelholtz JL et al. A randomized placebo-controlled trial comparing the efficacy of etoricoxib 30 mg and ibuprofen 2400 mg for the treatment of patients with osteoarthritis. Osteoarthritis Cartilage. 2007; 15: 1348-56.
15. Curtis SP, Bockow B, Fisher C et al. Etoricoxib in the treatment of osteoarthritis over 52-weeks: a double-blind, active-comparator controlled trial [NCT00242489]. BMC Musculoskelet Disord. 2005; 6: 58-68.
16. Stam W, Jansen J, Taylor S. Efficacy of etoricoxib, celecoxib, lumiracoxib, non-selective NSAIDs, and acetaminophen in osteoarthritis: a mixed treatment comparison. Open Rheumatol J. 2012; 6: 6-20.
17. JiaoYi P, YongQi S, KeChun G et al. Assessing the efficacy and safety of different nonsteroidal anti-inflammatory drugs in the treatment of osteoarthritis: A systematic review and network meta-analysis based on RCT trials. PLoS One. 2025; 20(5): e0320379.
18. Luksameesate P, Tanavalee A, Taychakhoonavudh S. An economic evaluation of knee osteoarthritis treatments in Thailand. Front Pharmacol. 2022; 13: 926431.
19. Cannon CP, Curtis SP, FitzGerald GA et al. Cardiovascular outcomes with etoricoxib and diclofenac in patients with osteoarthritis and rheumatoid arthritis in the Multinational Etoricoxib and Diclofenac Arthritis Longterm (MEDAL) programme: a randomised comparison. Lancet. 2006; 368: 1771-81.
20. Farkouh ME, Greenberg JD, Jeger RV et al. Cardiovascular outcomes in high risk patients with osteoarthritis treated with ibuprofen, naproxen or lumiracoxib. Ann Rheum Dis. 2007; 66: 764-70.
21. Wilner KD, Rushing M, Walden C et al. Celecoxib Does Not Affect the Antiplatelet Activity of Aspirin in Healthy Volunteers. J Clinical Pharmacol. 2002; 42: 1027-30.
22. van Walsem A, Pandhi S, Nixon RM et al. Relative benefit-risk comparing diclofenac to other traditional non-steroidal anti-inflammatory drugs and cyclooxygenase-2 inhibitors in patients with osteoarthritis or rheumatoid arthritis: a network meta-analysis. Arthritis Res Ther. 2015; 17: 66.
2. Klimiuk PA, Kuryliszyn-Moskal A. Choroba zwyrodnieniowa stawów. In: Reumatologia. Wielka Interna. Puszczewicz M (ed.). Medical Tribune Polska, Warszawa 2010: 273-290.
3. Aletaha D, Neogi T, Silman AJ et al. Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2010; 62: 2569-81.
4. Smolen J, Edwards C, Konzett V et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biologic disease-modifying antirheumatic drugs: 2025 update. Ann Rheum Dis. 2026; Mar 12: S0003-4967(26)00075-0.
5. Kearney PM, Baigent C, Godwin J et al. Do selective cyclo-oxygenase-2 inhibitors and traditional non-steroidal anti-inflammatory drugs increase the risk of atherothrombosis? Meta-analysis of randomised trials. BMJ. 2006; 332(7553): 1302-8.
6. Brune K, Patrigiani P. New insights into the use of currently available non-steroidal anti-inflammatory drugs. J Pain Res. 2015; 8:105-18.
7. Pharmindex.pl.
8. Collantes E, Curtis SP, Lee KW et al. A multinational randomized, controlled, clinical trial of etoricoxib in the treatment of rheumatoid arthritis [ISRCTN25142273]. BMC Fam Pract. 2002; 3: 10-20.
9. Kvien TK, Greenwald M, Peloso PM et al. Do COX-2 inhibitors provide additional pain relief and anti-inflammatory effects in patients with rheumatoid arthritis who are on biological disease-modifying anti-rheumatic drugs and/or corticosteroids? Post-hoc analyses from a randomized clinical trial with etoricoxib. BMC Musculoskelet Disord. 2015; 16: 26.
10. 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 Musculosklet Disord. 2016; 17: 331-42.
11. Krueger K, Lino L, Dore R et al. Gastrointestinal tolerability of etoricoxib in rheumatoid arthritis patients: results of the etoricoxib vs diclofenac sodium gastrointestinal tolerability and effectiveness trial (EDGE-II). Ann Rheum Dis. 2008; 67: 315-22.
12. 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.
13. Chen AI, Lee YH, Perng WT et al. Celecoxib and Etoricoxib may reduce risk of ischemic stroke in patients with rheumatoid arthritis: A nationwide retrospective cohort study. Front Neurol. 2022; 13: 1018521.
14. Puopolo A, Boice JA, Fidelholtz JL et al. A randomized placebo-controlled trial comparing the efficacy of etoricoxib 30 mg and ibuprofen 2400 mg for the treatment of patients with osteoarthritis. Osteoarthritis Cartilage. 2007; 15: 1348-56.
15. Curtis SP, Bockow B, Fisher C et al. Etoricoxib in the treatment of osteoarthritis over 52-weeks: a double-blind, active-comparator controlled trial [NCT00242489]. BMC Musculoskelet Disord. 2005; 6: 58-68.
16. Stam W, Jansen J, Taylor S. Efficacy of etoricoxib, celecoxib, lumiracoxib, non-selective NSAIDs, and acetaminophen in osteoarthritis: a mixed treatment comparison. Open Rheumatol J. 2012; 6: 6-20.
17. JiaoYi P, YongQi S, KeChun G et al. Assessing the efficacy and safety of different nonsteroidal anti-inflammatory drugs in the treatment of osteoarthritis: A systematic review and network meta-analysis based on RCT trials. PLoS One. 2025; 20(5): e0320379.
18. Luksameesate P, Tanavalee A, Taychakhoonavudh S. An economic evaluation of knee osteoarthritis treatments in Thailand. Front Pharmacol. 2022; 13: 926431.
19. Cannon CP, Curtis SP, FitzGerald GA et al. Cardiovascular outcomes with etoricoxib and diclofenac in patients with osteoarthritis and rheumatoid arthritis in the Multinational Etoricoxib and Diclofenac Arthritis Longterm (MEDAL) programme: a randomised comparison. Lancet. 2006; 368: 1771-81.
20. Farkouh ME, Greenberg JD, Jeger RV et al. Cardiovascular outcomes in high risk patients with osteoarthritis treated with ibuprofen, naproxen or lumiracoxib. Ann Rheum Dis. 2007; 66: 764-70.
21. Wilner KD, Rushing M, Walden C et al. Celecoxib Does Not Affect the Antiplatelet Activity of Aspirin in Healthy Volunteers. J Clinical Pharmacol. 2002; 42: 1027-30.
22. van Walsem A, Pandhi S, Nixon RM et al. Relative benefit-risk comparing diclofenac to other traditional non-steroidal anti-inflammatory drugs and cyclooxygenase-2 inhibitors in patients with osteoarthritis or rheumatoid arthritis: a network meta-analysis. Arthritis Res Ther. 2015; 17: 66.