Skip to main content
SpringerLink
Log in

Efficacy of celecoxib, meloxicam and paracetamol in elderly Kashin-Beck Disease (KBD) patients

International Orthopaedics volume 35, pages 1409–1414 (2011)Cite this article

Abstract

The objective of this study was to compare the efficacy and tolerability of celecoxib, meloxicam and paracetamol in late Kashin-Beck disease. Adults (n = 168) with Kashin-Beck disease were randomised in clusters to receive six week courses of celecoxib 200 mg once daily, meloxicam 7.5 mg once daily or paracetamol 300 mg three times daily. Efficacy assessments included overall joint pain intensity and Western Ontario and McMaster Universities Osteoarthritis Index subscales; tolerability was evaluated by adverse event and physician reporting. Celecoxib and meloxicam were efficacious in relieving pain and improving stiffness, but unable to improve physical function after six weeks. Paracetamol was efficacious in relieving pain, but unable to improve morning stiffness and physical function after six weeks. Celecoxib and meloxicam provide predictable and sustained relief from pain and stiffness. Paracetamol can relieve the pain. None of the treatments improved impaired physical function in Kashin-Beck disease.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3

References

  1. Yang C, Niu C, Bodo M, Gabriel E, Notbohm H, Wolf E, Müller PK (1993) Fulvic acid supplementation and selenium deficiency disturb the structural integrity of mouse skeletal tissue. An animal model to study the molecular defects of Kashin-Beck disease. Biochem J 289(Pt 3):829–835

    PubMed  CAS  Google Scholar 

  2. Wang Y, Yang Z, Gilula LA, Zhu C (1996) Kashin-Beck disease: radiographic appearance in the hands and wrists. Radiology 201:265–270

    PubMed  CAS  Google Scholar 

  3. Chasseur C, Suetens C, Nolard N, Begaux F, Haubruge E (1997) Fungal contamination in barley and Kashin-Beck disease in Tibet. Lancet 350:1074

    Article  PubMed  CAS  Google Scholar 

  4. Haubruge E, Chasseur C, Debouck C, Begaux F, Suetens C, Mathieu F, Michel V, Gaspar C, Rooze M, Hinsenkamp M, Gillet P, Nolard N, Lognay G (2001) The prevalence of mycotoxins in Kashin-Beck disease. Int Orthop 25:159–161

    Article  PubMed  CAS  Google Scholar 

  5. Moreno-Reyes R, Suetens C, Mathieu F, Begaux F, Zhu D, Rivera MT, Boelaert M, Nève J, Perlmutter N, Vanderpas J (1998) Kashin-Beck osteoarthropathy in rural Tibet in relation to selenium and iodine status. N Engl J Med 339:1112–1120

    Article  PubMed  CAS  Google Scholar 

  6. Moreno-Reyes R, Mathieu F, Boelaert M, Begaux F, Suetens C, Rivera MT, Nève J, Perlmutter N, Vanderpas J (2003) Selenium and iodine supplementation of rural Tibetan children affected by Kashin-Beck osteoarthropathy. Am J Clin Nutr 78:137–144

    PubMed  CAS  Google Scholar 

  7. La Grange M, Mathieu F, Begaux F, Suetens C, Durand MC (2001) Kashin-Beck disease and drinking water in Central Tibet. Int Orthop 25:167–169

    Article  PubMed  Google Scholar 

  8. Zhai SS, Kimbrough RD, Meng B, Han JY, LeVois M, Hou X, Yin XN (1990) Kashin-Beck disease: a cross-sectional study in seven villages in the People’s Republic of China. J Toxicol Environ Health 30:239–259

    Article  PubMed  CAS  Google Scholar 

  9. Moerman J, Uyttendaele D, Van den Broecke W, Claessens H (1992) Kashin-Beck’s disease. Acta Orthop Belg 58:227–230

    PubMed  CAS  Google Scholar 

  10. Mathieu F, Begaux F, Lan ZY, Suetens C, Hinsenkamp M (1997) Clinical manifestations of Kashin-Beck disease in Nyemo Valley, Tibet. Int Orthop 21:151–156

    Article  PubMed  CAS  Google Scholar 

  11. Hinsenkamp M, Ryppens F, Begaux F, Mathieu F, De Maertelaer V, Lepeire M, Haubruge E, Chasseur C, Stallenberg B (2001) The anatomical distribution of radiological abnormalities in Kashin-Beck disease in Tibet. Int Orthop 25:142–146

    Article  PubMed  CAS  Google Scholar 

  12. Hinsenkamp M, Mathieu F, Claus W, Collard JF, de Maertelaer V (2009) Effects of physical environment on the evolution of Kashin-Beck disease in Tibet. Int Orthop 33:1085–1088

    Article  PubMed  CAS  Google Scholar 

  13. Liu FD, Wang ZL, Hinsenkamp M (1998) Osteotomy at the knee for advanced cases of Kashin-Beck disease. Int Orthop 22:87–91

    Article  PubMed  CAS  Google Scholar 

  14. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840

    PubMed  CAS  Google Scholar 

  15. Mathieu F, Suetens C, Begaux F, De Maertelaer V, Hinsenkamp M (2001) Effects of physical therapy on patients with Kashin-Beck disease in Tibet. Int Orthop 25:191–193

    Article  PubMed  CAS  Google Scholar 

  16. FitzGerald GA, Patrono C (2001) The coxibs, selective inhibitors of cyclooxygenase-2. N Engl J Med 345:433–442

    Article  PubMed  CAS  Google Scholar 

  17. Bensen WG, Fiechtner JJ, McMillen JI, Zhao WW, Yu SS, Woods EM, Hubbard RC, Isakson PC, Verburg KM, Geis GS (1999) Treatment of osteoarthritis with celecoxib, a cyclooxygenase-2 inhibitor: a randomized controlled trial. Mayo Clin Proc 74:1095–1105

    Article  PubMed  CAS  Google Scholar 

  18. Williams GW, Ettlinger RE, Ruderman EM, Hubbard RC, Lonien ME, Yu SS, Zhao W, Geis GS (2000) Treatment of osteoarthritis with a once-daily dosing regimen of celecoxib: a randomized, controlled trial. J Clin Rheumatol 6:65–74

    Article  PubMed  CAS  Google Scholar 

  19. McKenna F, Borenstein D, Wendt H, Wallemark C, Lefkowith JB, Geis GS (2001) Celecoxib versus diclofenac in the management of osteoarthritis of the knee. Scand J Rheumatol 30:11–18

    Article  PubMed  CAS  Google Scholar 

  20. Patrignani P, Panara MR, Sciulli MG, Santini G, Renda G, Patrono C (1997) Differential inhibition of human prostaglandin endoperoxide synthase-1 and -2 by nonsteroidal anti-inflammatory drugs. J Physiol Pharmacol 48:623–631

    PubMed  CAS  Google Scholar 

  21. Pairet M, van Ryn J, Schierok H, Mauz A, Trummlitz G, Engelhardt G (1998) Differential inhibition of cyclooxygenases-1 and -2 by meloxicam and its 4′-isomer. Inflamm Res 47:270–276

    Article  PubMed  CAS  Google Scholar 

  22. Hochberg MC, Altman RD, Brandt KD, Clark BM, Dieppe PA, Griffin MR, Moskowitz RW, Schnitzer TJ (1995) Guidelines for the medical management of osteoarthritis. Part I. Osteoarthritis of the hip. American College of Rheumatology. Arthritis Rheum 38:1535–1540

    Article  PubMed  CAS  Google Scholar 

  23. Hochberg MC, Altman RD, Brandt KD, Clark BM, Dieppe PA, Griffin MR, Moskowitz RW, Schnitzer TJ (1995) Guidelines for the medical management of osteoarthritis. Part II. Osteoarthritis of the knee. American College of Rheumatology. Arthritis Rheum 38:1541–1546

    Article  PubMed  CAS  Google Scholar 

  24. Eisen SA, Miller DK, Woodward RS, Spitznagel E, Przybeck TR (1990) The effect of prescribed daily dose frequency on patient medication compliance. Arch Intern Med 150:1881–1884

    Article  PubMed  CAS  Google Scholar 

  25. Salzman C (1995) Medication compliance in the elderly. J Clin Psychiatry 56(Suppl 1):18–22, discussion 23

    PubMed  Google Scholar 

  26. Simon LS, Lanza FL, Lipsky PE, Hubbard RC, Talwalker S, Schwartz BD, Isakson PC, Geis GS (1998) Preliminary study of the safety and efficacy of SC-58635, a novel cyclooxygenase 2 inhibitor: efficacy and safety in two placebo-controlled trials in osteoarthritis and rheumatoid arthritis, and studies of gastrointestinal and platelet effects. Arthritis Rheum 41:1591–1602

    Article  PubMed  CAS  Google Scholar 

  27. Silverstein FE, Faich G, Goldstein JL, Simon LS, Pincus T, Whelton A, Makuch R, Eisen G, Agrawal NM, Stenson WF, Burr AM, Zhao WW, Kent JD, Lefkowith JB, Verburg KM, Geis GS (2000) Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis: the CLASS study: a randomized controlled trial. Celecoxib Long-term Arthritis Safety Study. JAMA 284:1247–1255

    Article  PubMed  CAS  Google Scholar 

  28. Deeks JJ, Smith LA, Bradley MD (2002) Efficacy, tolerability, and upper gastrointestinal safety of celecoxib for treatment of osteoarthritis and rheumatoid arthritis: systematic review of randomised controlled trials. BMJ 325:619

    Article  PubMed  CAS  Google Scholar 

  29. Mamdani M, Rochon PA, Juurlink DN, Kopp A, Anderson GM, Naglie G, Austin PC, Laupacis A (2002) Observational study of upper gastrointestinal haemorrhage in elderly patients given selective cyclo-oxygenase-2 inhibitors or conventional non-steroidal anti-inflammatory drugs. BMJ 325:624

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The authors gratefully acknowledge the contribution made by Bing Li (secretary).

Disclosures

The authors declare that they have no competing interests.

Author information

Authors and Affiliations

  1. Department of Immunology and Rheumatology, West China Hospital, West China Medical School, Sichuan University, No. 17, Section 3, Southern Renmin Road, Chengdu, 610041, People’s Republic of China

    Rui Luo, Gang Liu, Wei Liu, Qibing Xie & Xin Ma

  2. Rheumatology Research Unit, State Key Laboratory, West China Hospital, West China Medical School, Sichuan University, Chengdu, People’s Republic of China

    Gang Liu

  3. Department of Osteology, West China Hospital, West China Medical School, Sichuan University, Chengdu, People’s Republic of China

    Fuxing Pei, Zongke Zhou, Jian Li, Bin Shen & Pengde Kang

Authors
  1. Rui Luo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gang Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wei Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fuxing Pei
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Zongke Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jian Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Bin Shen
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Pengde Kang
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Qibing Xie
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Xin Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gang Liu.

Additional information

This study was partially supported by a grant from NSFC (Natural Science support project Item of China) 2007BA125B04 to Dr. Fuxing Pei ChiCTR-TCR-000000395.

Appendix

Appendix

Investigators

In the Medical College of Sichuan University, West China Hospital: Gang Liu, Luo Rui, Wei Liu, Yongtao Cheng, Dan Hu, Jiangang Wang, Li Li, Xin Ma, (rheumatologist), Fuxing Pei, Zongke Zhou, Jian Li, Bin Shen, Pengde Kang (orthopaedist); in the North Sichuan Medical College: JianPing Liu (rheumatologist); in the People’s Hospital of Sichuan province: JIanxin Zhu, Liuyi Tang, Chongxin Huang (orthopaedist); in the Chengdu Medical University of Chinese Medicine: Qun Gao (orthopaedist).

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Luo, R., Liu, G., Liu, W. et al. Efficacy of celecoxib, meloxicam and paracetamol in elderly Kashin-Beck Disease (KBD) patients. International Orthopaedics (SICOT) 35, 1409–1414 (2011). https://doi.org/10.1007/s00264-010-1062-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-010-1062-0

Keywords

search

Navigation