• Nathaniel Katz, William D Ju, David A Krupa, Rhoda S Sperling, Diana Bozalis Rodgers, Barry J Gertz, Joseph Gimbel, Spencer Coleman, Chester Fisher, Shahriar Nabizadeh, David Borenstein, and Vioxx Chronic Low Back Pain Study Group.
• Pain Trials Center, Brigham & Women's Hospital, Boston, Massachusetts, USA. NatPaulKatz@aol.com
• Spine. 2003 May 1;28(9):851-8; discussion 859.

Study DesignTwo replicate, 4-week, randomized, double-blind, placebo-controlled, trials of rofecoxib 25 and 50 mg versus placebo for chronic low back pain.ObjectivesTo determine the efficacy and safety of two doses of rofecoxib compared to placebo in the treatment of chronic low back pain.Summary Of Background DataAlthough nonsteroidal anti-inflammatory drugs are commonly prescribed for chronic low back pain, their efficacy is unproven and toxicity can be serious. These studies evaluated the efficacy and tolerability of rofecoxib, a selective COX-2 inhibitor, in the treatment of chronic low back pain.MethodsPatients with chronic low back pain were randomized 1:1:1 to rofecoxib 25 mg, 50 mg, or placebo once daily. Primary endpoint: Low Back Pain Intensity. Secondary endpoints: Pain Bothersomeness, Global Assessments of Response to Therapy, Global Assessment of Disease Status, Roland-Morris Disability Questionnaire, SF-12 Health Survey, Use of Rescue Acetaminophen, and Discontinuations Due to Lack of Efficacy.ResultsCombining both studies, 690 patients were randomized to placebo (N = 228), rofecoxib 25 mg (N = 233), or rofecoxib 50 mg (N = 229). Mean (+/- SD) age was 53.4 (+/- 12.9) years, pain duration 12.1 (+/- 11.8) years, 62.3% female. Both rofecoxib groups improved significantly. Mean differences from placebo in pain intensity were -13.50 mm, -13.81 mm (25, 50 mg doses) respectively (P < 0.001). Both regimens were superior to placebo in eight of nine secondary endpoints. Fifty mg provided no advantage over 25 mg. Both rofecoxib regimens were well tolerated, although 25 mg had a slightly better safety profile.ConclusionsRofecoxib significantly reduced chronic low back pain in adults and was well tolerated.

30 keywords...

hide…