Abstract
Objective
Imrecoxib is a novel cyclooxygenase-2 inhibitor independently developed in China, which exhibits a good efficacy and tolerance in orthopedic disorders. The current study aimed to further compare its efficacy and safety with celecoxib as postoperative analgesia in arthroscopic knee surgery (AKS).
Methods
Patients receiving AKS were enrolled and randomly assigned to imrecoxib (n = 64) and celecoxib (n = 62) group to receive analgesia for 72 h after surgery. Pain at rest and movement, pethidine consumption, patient’s satisfaction, Lysholm score, and adverse events were assessed after AKS. Meanwhile the upper limit of 95% CI of pain-score mean difference (MD) between imrecoxib and celecoxib was calculated, then, the non-inferiority was defined if the all-time-point upper limits of 95% CI less than 1.
Results
Imrecoxib was non-inferior to celecoxib for alleviating pain at rest (upper limit of 95% CI of MD ranging from 0.443 to 0.782, all time-point values less than 1); as well as for attenuating pain at movement (upper limit of 95% CI of MD ranging from 0.398 to 0.582, all time-point values less than 1). Moreover, rescue analgesia rate (P = 0.583), pethidine consumption (P = 0.454), patient’s satisfaction at 72 h (P = 0.408), and Lysholm score at M3 (P = 0.776) were of no difference between imrecoxib group and celecoxib group. Additionally, the main adverse events in two groups were nausea (P = 0.425), constipation (P = 1.000), vomiting (P = 0.715), headache (P = 1.000), and dizziness (P = 0.667), which were mild and manageable.
Conclusion
Imrecoxib is non-inferior to celecoxib in postoperative analgesia and exhibits an acceptable tolerance in patients undergoing AKS.
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Data availability
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
References
Basques BA, Saltzman BM, Korber SS, Bolia IK, Mayer EN, Bach BR, Verma NN, Cole BJ, Weber AE (2020) Resident involvement in arthroscopic knee surgery is not associated with increased short-term risk to patients. Orthop J Sports Med 8:2325967120967460
Brignardello-Petersen R, Guyatt GH, Buchbinder R, Poolman RW, Schandelmaier S, Chang Y, Sadeghirad B, Evaniew N, Vandvik PO (2017) Knee arthroscopy versus conservative management in patients with degenerative knee disease: a systematic review. BMJ Open 7:e016114
Erden A, Emirzeoglu M (2021) Factors affecting the satisfaction levels of patients who underwent orthopedic knee surgery in the early postoperative period. J Patient Exp 8:23743735211043390
Feng Z, Chu F, Guo Z, Sun P (2009) Synthesis and anti-inflammatory activity of the major metabolites of imrecoxib. Bioorg Med Chem Lett 19:2270–2272
Gao GM, Li YM, Zheng XL, Jiang DB, Zhang LL, Xu PH, Liu SY, Zheng ZH, Kan QC (2017) The efficacy of imrecoxib and celecoxib in axial spondyloarthritis and their influence on serum dickopff-related protein 1 (DKK-1) levels. Med Sci Monit 23:2985–2992
Gatewood CT, Tran AA, Dragoo JL (2017) The efficacy of post-operative devices following knee arthroscopic surgery: a systematic review. Knee Surg Sports Traumatol Arthrosc 25:501–516
Jiang Y, Qi L, Liu J, Wu H, Li Y, Zou L, Guo Z, Wang J, Li H (2021) Analgesic efficacy of imrecoxib for postoperative pain following oral surgery: a prospective randomized, active-controlled, non-inferiority trial. Ann Transl Med 9:469
Li Y, Wang J, Huang J, Yu J, Wang Y, Tan H, Zhang H, Yang G, Pei Q (2020) Dose investigation of imrecoxib in patients with renal insufficiency based on modelling and simulation. Eur J Pharm Sci 152:105449
Li HZ, Yu C, Zhang ZT, Yan S, Liao YJ, Lu DF (2021) Arthroscopic reconstruction of posterior cruciate ligament with embedded tibial tendon bolt. Orthop Surg 13:592–598
Liu J, Di J, Zhang Y, Xing E (2021) Oxycodone-paracetamol tablet exhibits increased analgesic efficacy for acute postoperative pain, higher satisfaction and comparable safety profiles compared with celecoxib in patients underwent arthroscopic knee surgery. Inflammopharmacology 29:1091–1099
Ma L, Zhang L, Wang H, Jiang C (2021) Efficiency and safety: comparison between preoperative analgesia and postoperative analgesia using non-steroidal anti-inflammatory drugs in patients receiving arthroscopic knee surgery in a multicenter, randomized, controlled study. Inflammopharmacology 29:651–659
Pedersen JR, Roos EM, Thorlund JB, Terluin B, Ingelsrud LH (2021) Cutoff values to interpret short-term treatment outcomes after arthroscopic meniscal surgery, measured with the knee injury and osteoarthritis outcome score. J Orthop Sports Phys Ther 51:281–288
Pei Q, Xie JL, Huang J, Liu WY, Yang XY, Wang Y, Li W, Tan HY, Zhang H, Yang GP (2019) Pharmacokinetic study of imrecoxib in patients with renal insufficiency. Eur J Clin Pharmacol 75:1355–1360
Sonesson S, Kvist J, Yakob J, Hedevik H, Gauffin H (2020) Knee arthroscopic surgery in middle-aged patients with meniscal symptoms: a 5-year follow-up of a prospective, randomized study. Orthop J Sports Med 8:2325967119893920
Sun X, Zhen X, Hu X, Li Y, Gu S, Gu Y, Zhao Z, Yang W, Dong H (2021) Cost-utility analysis of imrecoxib compared with celecoxib for patients with osteoarthritis. Ann Transl Med 9:575
Tharion JG, Kale S (2021) Patient satisfaction through an immersive experience using a mobile phone-based head-mounted display during arthroscopic knee surgery under spinal anesthesia: a randomized clinical trial. Anesth Analg 133:940–948
Thorlund JB, Juhl CB, Roos EM, Lohmander LS (2015) Arthroscopic surgery for degenerative knee: systematic review and meta-analysis of benefits and harms. BMJ 350:h2747
Wang CL, Chen JB, Li T (2021) Outcome and experience of arthroscopic lateral retinacular release combined with lateral patelloplasty in the management of excessive lateral pressure syndrome. J Orthop Surg Res 16:80
Winter AR, Collins JE, Katz JN (2017) The likelihood of total knee arthroplasty following arthroscopic surgery for osteoarthritis: a systematic review. BMC Musculoskelet Disord 18:408
Wu ZP, Zhang P, Bai JZ, Liang Y, Chen PT, He JS, Wang JC (2018) Comparison of navigated and conventional high tibial osteotomy for the treatment of osteoarthritic knees with varus deformity: a meta-analysis. Int J Surg 55:211–219
Xie Y, Tu L, Zhang Y, Yu Q, Wu H, Ye S, Li H, Chen Z, Wu J, Cao S, Wei Q, Gu J (2022) Efficacy and safety of Fengshi Gutong Capsule in patients with active ankylosing spondylitis: a 4-week randomized controlled, double-blinded, double-dummy trial. J Ethnopharmacol 285:114731
Yang J, Ni B, Fu X (2021) Efficacy of intra-articular ketorolac for pain control in arthroscopic surgeries: a systematic review and meta-analysis. J Orthop Surg Res 16:688
Zuo CZ, Gong Y, Hou XY, Zhang YF, Peng WX, Zhu RH, Zhong DF, Chen XY (2018) Effect of fluconazole on the pharmacokinetic properties of imrecoxib, a novel NSAID: a single-center, open-label, self-controlled study in healthy chinese male volunteers. Clin Ther 40:1347–1356
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Guo, W., Liu, Y. & Li, J. Imrecoxib versus celecoxib as postoperative analgesia for patients receiving arthroscopic knee surgery: a randomized, controlled, non-inferiority study. Inflammopharmacol 30, 875–881 (2022). https://doi.org/10.1007/s10787-022-00938-8
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DOI: https://doi.org/10.1007/s10787-022-00938-8