Reachout Orthopedics - Issue 1

120 mg administered orally once daily is effective for treatment of acute gout. As a meta-analysis for randomized studies, there are several limitations to our studies. First, this meta-analysis is limited primarily because of the small quantity of original studies, and the included studies have small sample sizes. To confirm this assessment, high-quality and more RCTs must be conducted. Furthermore, because of small sample size, subgroup analysis was not performed on polyarticular and monoarticular gouts. Second, all of the studies included in this meta-analysis are RCTs, but in some articles, allocation concealment, blinding of participants and personnel, blinding of outcome assessment, and other biases were unclear; these studies were more likely to suffer from various kinds of bias. Furthermore, confounding factors such as underlying disease and the use of other drugs can confuse the outcome. However, there is still no way for controlling these confounding factors and bias and no established method for assessing how these confounding factors and bias affect the overall outcome. Third, no authors were contacted for further information. We extracted the data either directly from the article or through extrapolation by us. Conclusion We believe, from this meta-analysis, we found that etoricoxib has similar anti-inflammatory and analgesic effects as indomethacin in the treatment of acute gout. Furthermore, etori- coxib has a significantly lower risk of AEs than indomethacin. Etoricoxib 120 mg ad- ministered orally once daily may be effective for the treatment of acute gouty arthritis. Abbreviations NSAIDs-Non-steroidal anti-inflammatory drugs; RCTs- Randomized controlled trials; AEs-Adverse events; EG- Experimental group; CG-Control group; SS-Sample size; RR-Relative risk; WMD-Weighted mean difference. Disclosures: None. Author contributions: The intent of this statement is to display our idea on acute gout. SZ and JW conceived and designed the experiments. All authors participated in the literature search, assessment of bias, and data analysis. Data extraction was performed by SZ and checked by JW. SZ wrote the paper and PL made modifications. References available on request Healthcare.India@springer.com Source: Shaobo Zhang, Yibao Zhang, Peng Liu, et al . Efficacy and safety of etoricoxib compared with NSAIDs in acute gout: a systematic review and a meta-analysis. Clin Rheumatol . 2016; 35(1):151–158. DOI 10.1007/s10067-015-2991-1. © International League of Associations for Rheumatology (ILAR) 2015. Fig. 5: Forest plot of mean difference in adverse events and 95% CI. Fig. 6: Forest plot of mean difference in gastrointestinal tract side effects and dizziness and 95% CI. 120 mg administered orally once daily has the same anti-inflammatory and analgesic effects as NSAIDs. For the safety assessment, any AE, drug-related AEs, and serious AEs, had pooled RR values of 0.77 (95% CI: 0.64 to 0.93, p =0.006), 0.64 (95% CI: 0.50 to 0.81, p =0.0003), and 0.42 (95% CI: 0.09 to 1.93, p =0.27).These results indicate that etoricoxib has fewer complications than NSAIDs. For drug-related AEs, there was a significant difference between the two interventions, with etoricoxib having fewer complications than NSAIDs. For gastrointestinal tract side effects, the pooled RR was 0.42 (95% CI: 0.27 to 0.66, p =0.0002). For dizziness, the pooled RR value was 0.37 (95% CI: 0.16 to 0.85, p =0.02). Both of these AEs were significantly more common in the NSAID group than in the etoricoxib group. All trials apply the intervention methods of etoricoxib 120 mg administered orally once daily, and Leclercq [28] recommended etoricoxib at a dosage of 60 mg/day for osteoarthritis, 90 mg/day for rheumatoid arthritis, and 120 mg/day for acute gout. So we believe that etoricoxib 12 reachOut Orthopedics