The analgesic efficacy of valdecoxib vs. oxycodone/acetaminophen after oral surgery.
BACKGROUND
The authors conducted two studies to compare the analgesic efficacy and safety of the cyclooxygenase, or COX, -2-specific inhibitor, valdecoxib, with oxycodone/ acetaminophen in patients who have undergone oral surgery.


METHODS
In total, 205 eligible subjects in Study A and 201 in Study B were randomized to receive a single oral dose of valdecoxib (20 or 40 milligrams), a combination of oxycodone 10 mg/acetaminophen 1,000 mg or placebo. Eligible subjects experienced moderate-to-severe pain within six hours of surgery during which two or more impacted third molars were extracted. Analgesic efficacy was assessed over 24 hours or until the patient required rescue analgesia.


RESULTS
In both studies, subjects receiving either dose of valdecoxib experienced a rapid onset of analgesia and (among those who received valdecoxib 40 mg) a level of pain relief comparable with that of those who received oxycodone/ acetaminophen. Both valdecoxib doses had a significantly longer duration of analgesic effect than did oxycodone/acetaminophen. Pooled safety data demonstrated that each valdecoxib dose had a tolerability profile superior to that of oxycodone/ acetaminophen and similar to that of placebo.


CONCLUSIONS
Orally administered valdecoxib is as rapidly acting and effective as oxycodone/acetaminophen, and it has a superior duration of analgesic effect in patients after oral surgery. Valdecoxib has a tolerability profile superior to that of oxycodone/acetaminophen.


CONCLUSIONS
The current standard of care for alleviating acute pain after oral surgery has rested largely on conventional nonsteroidal anti-inflammatory drugs or opioid/analgesic combination products. The studies reported here suggest that the COX-2-specific inhibitor valdecoxib offers an efficacious and safe alternative to other analgesics used to treat pain after oral surgery.
Daniels
Stephen E
SE
Clinical Site Operations, SCIREX Corp., Austin, Texas, USA.
Desjardins
Paul J
PJ
Talwalker
Sheela
S
Recker
David P
DP
Verburg
Kenneth M
KM
D000082:Acetaminophen / Q000008:administration & dosage*; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000704:Analysis of Variance; D003257:Consumer Product Safety; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage*; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007555:Isoxazoles / Q000008:administration & dosage*; D008297:Male; D008964:Molar, Third / Q000601:surgery; D010098:Oxycodone / Q000008:administration & dosage*; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D013449:Sulfonamides / Q000008:administration & dosage*; D014081:Tooth Extraction / Q000009:adverse effects*; D014095:Tooth, Impacted / Q000601:surgery; D000096926:Benzenesulfonamides
D000082:Acetaminophen; D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D016861:Cyclooxygenase Inhibitors; D004338:Drug Combinations; D007555:Isoxazoles; D010098:Oxycodone; D013449:Sulfonamides; C406224:valdecoxib; D000096926:Benzenesulfonamides