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Imrecoxib matches celecoxib in efficacy and safety, with fewer adverse events in osteoarthritis and potential anti-inflammatory benefits in axSpA.
Evidence pooled from randomized controlled trials (RCTs) indicates that imrecoxib provides pain relief and anti-inflammatory effects comparable to celecoxib, with a possible advantage in tolerability for osteoarthritis (OA) and encouraging anti-inflammatory signals in axial spondyloarthritis (axSpA).
In this systematic review and meta-analysis, researchers conducted an extensive search of English and Chinese databases to identify RCTs directly comparing the two selective cyclooxygenase-2 (COX-2) inhibitors. The primary outcomes included clinical response rate, pain intensity measured via visual analog scale (VAS), and overall incidence of adverse events. Secondary outcomes focused on inflammatory biomarkers (like C-reactive protein [CRP] and erythrocyte sedimentation rate [ESR]) and disease activity assessed by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in axSpA patients.
There were no prominent differences between imrecoxib and celecoxib in clinical response rates or VAS pain reduction, confirming comparable analgesic potency. Adverse events incidence was comparable between the two drugs across the overall population. In the OA subgroup, imrecoxib was linked with a markedly lower incidence of adverse events when compared with celecoxib, suggesting a better tolerability profile in OA patients. For axSpA, exploratory subgroup analysis indicated that imrecoxib may improve CRP, ESR, and BASDAI scores more than celecoxib, pointing toward a potential enhanced anti-inflammatory effect.
But, these results were based on a small number of trials with limited sample sizes, resulting in low-certainty evidence. Overall, imrecoxib proved non-inferior to celecoxib in terms of pain relief and overall safety, supporting its use as an alternative COX-2 inhibitor in clinical practice. The reduced adverse event rate in OA and possible superiority in inflammatory control in axSpA are clinically relevant signals but require confirmation.
Frontiers in Pharmacology
Comparative efficacy and safety of imrecoxib versus celecoxib: a systematic review and meta-analysis
Xian Zeng et al.
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