Do n-of-1 trials of celeocxib compared to sustained release paracetamol change patient use of drugs for osteoarthritis?

Yelland, Michael, Nikles, Jane, McNairn, Norma, Brown, Robyn, Del Mar, Christopher and Schluter, Philip (2006). Do n-of-1 trials of celeocxib compared to sustained release paracetamol change patient use of drugs for osteoarthritis?. In: RACGP 49th Annual Scientific Convention: Be the Future, Brisbane, QLD, Australia, (101-101). 5-8 October 2006.

Author Yelland, Michael
Nikles, Jane
McNairn, Norma
Brown, Robyn
Del Mar, Christopher
Schluter, Philip
Title of paper Do n-of-1 trials of celeocxib compared to sustained release paracetamol change patient use of drugs for osteoarthritis?
Conference name RACGP 49th Annual Scientific Convention: Be the Future
Conference location Brisbane, QLD, Australia
Conference dates 5-8 October 2006
Publication Year 2006
Sub-type Other
Start page 101
End page 101
Total pages 1
Language eng
Formatted Abstract/Summary
Objective
To assess the use of n-of-1 trials for short term choice of drugs for osteoarthritis, with particular reference to comparing the efficacy of sustained release (SR) paracetamol and celecoxib in individual patients.

Methods
Evaluation of community based patients undergoing n-of-1 trials which consisted of double blind, cross over comparisons of celecoxib 200 or 400 mg daily vs sustained release paracetamol 1330 mg three times daily in three pairs of 2 week treatment periods with randomisation of medication within pairs. Outcomes were pain and stiffness in sites nominated by the patient, functional limitation scores, preferred medication, side effects and changes in drug use after an n-of-1 trial. Participants were 59 patients with osteoarthritis (with pain for 1 month) severe enough to warrant consideration of long term use of celecoxib but for whom there was doubt about its efficacy. Forty-one n-of-1 trials were completed.

Results
For 33/41 (80%) the overall symptom relief by celecoxib and SR paracetamol was equivalent. Management after the n-of-1 trial was concordant with its result for 19 of these (13 generally using SR paracetamol, six celecoxib). Symptom relief for celecoxib and SR paracetamol was not equivalent for the remaining eight patients: celecoxib provided better relief for seven (17%). In 25/41 (61%) of patients, subsequent management was consistent with their trial results.

Conclusions
N-of-1 trials may provide a rational and effective method to best choose drugs for individuals with osteoarthritis. Sustained - release paracetamol is more useful than celecoxib for most patients whose management is uncertain.
Q-Index Code EX
Q-Index Status Provisional Code
Institutional Status UQ
Additional Notes Abstract guide, pg 101.

Document type: Conference Paper
Collection: School of Medicine Publications
 
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Created: Sun, 21 Nov 2010, 17:06:20 EST by Dr Jane Nikles on behalf of Discipline of General Practice