Observational Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2019; 7(23): 3971-3979
Published online Dec 6, 2019. doi: 10.12998/wjcc.v7.i23.3971
Comparison of intra-articular injection of parecoxib vs oral administration of celecoxib for the clinical efficacy in the treatment of early knee osteoarthritis
Lu Lu, Yu Xie, Ke Gan, Xiao-Wen Huang
Lu Lu, Yu Xie, Ke Gan, Department of Rheumatology, Affiliated Hospital of Nanjing University of Chinese Medicine (Jiangsu Province Hospital of Chinese Medicine), Nanjing 210029, Jiangsu Province, China
Xiao-Wen Huang, Department of Orthopedics, First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing 210029, Jiangsu Province, China
Author contributions: Lu L and Huang XW contributed to study conception and design; Lu L, Xie Y and Gan K contributed to data acquisition, data analysis and interpretation, and writing of article; all of authors contributed to editing, reviewing and final approval of article.
Supported by National Natural Science Foundation of China, NO. 81774274; and Project of Jiangsu Provincial Hospital of Traditional Chinese Medicine, NO. Y19058.
Institutional review board statement: The study was approved by the Ethics Committee of Affiliated Hospital of Nanjing University of Chinese Medicine.
Informed consent statement: All patients gave informed consent.
Conflict-of-interest statement: All authors have declared that no conflict of interest exists.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement, and the manuscript was prepared and revised according to the STROBE Statement.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xiao-Wen Huang, MD, Professor, Department of Orthopedics, First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), No. 300 Guangzhou Road, Nanjing 210029, Jiangsu Province, China. jiangsuaaa@aliyun.com
Telephone: +86-25-86624213 Fax: +86-25-86624213
Received: September 30, 2019
Peer-review started: September 30, 2019
First decision: October 23, 2019
Revised: November 5, 2019
Accepted: November 15, 2019
Article in press: November 15, 2019
Published online: December 6, 2019
Processing time: 67 Days and 4 Hours
ARTICLE HIGHLIGHTS
Research background

Oral non-steroid anti-inflammatory drugs (NSAIDs) are often used for the treatment of osteoarthritis. However, in elderly people, oral NSAIDs have certain side-effects especially in the incidence of adverse gastrointestinal reactions and cardiovascular risk. Meanwhile, the compliance with long-term use of NSAIDs is low in early osteoarthritis.

Research motivation

A new solution is needed for patients with early osteoarthritis, especially for those who cannot take NSAIDS orally. Intra-articular injection of drugs is a direct and effective treatment. It is a challenge to find suitable NSAIDs for intra-articular injection. Parecoxib is conventionally used for postoperative analgesia by an intravenous route of administration in the surgery department. The feasibility and effectiveness of the intra-articular injection of parecoxib should be explored.

Research objectives

A retrospective study was performed to observe and investigate the clinical efficacy of the intra-articular injection of Parecoxib to treat patients with early knee osteoarthritis (KOA).

Research methods

Three groups of patients (110 cases in total) underwent interventions of three separate treatment methods. By comparing visual analogue scale (VAS), Hospital for Special Surgery (HSS) scores and levels of different inflammatory cytokines in synovial fluid before and after treatment, the clinical efficacy of intra-articular injections of Parecoxib were evaluated.

Research results

The clinical efficacy of the intra-articular injection group in the treatment of early KOA was confirmed to be superior to the others, whether it be in terms of VAS and HSS scores or the variation of different inflammatory cytokine levels.

Research conclusions

Compared with oral NSAIDS, intra-articular injection of Parecoxib has better clinical efficacy in the treatment of early KOA. This method can avoid the side-effects associated with the long-term oral use of NSAIDs, and should be an option for clinical application.

Research perspectives

Osteoarthritis treatment methods require continual improvement and optimization. More randomized clinical trial studies are always necessary to improve and verify our findings.