Huang H, Luo M, Liang H, et al. Meta-analysis Comparing Celecoxib with Diclofenac Sodium in Patients with Knee Osteoarthritis. Pain Med. 2020 Aug 14. pii: 5892885. doi: 10.1093/pm/pnaa230. (Systematic review)

OBJECTIVE: To compare the efficacy and safety of celecoxib and diclofenac sodium in patients with knee osteoarthritis (KOA).

METHODS: Clinical controlled trials (CCTs) and randomized controlled trials (RCTs) from online databases comparing the efficacy of celecoxib and diclofenac sodium in the treatment of KOA were retrieved. The main outcomes included the treatment effect, C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), visual analog scale (VAS) score, and complication rate. The Cochrane risk of bias (ROB) tool in Review Manager 5.3.5 was used to assess methodological quality.

RESULTS: Twelve studies (N = 2,350) were included in this meta-analysis. The meta-analysis indicated that celecoxib reduced pain more effectively than diclofenac sodium in patients with KOA, as evaluated by the VAS score. In addition, celecoxib has certain advantages in terms of better treatment effects and greater reductions in the ESR, CRP level, and complication rate.

CONCLUSIONS: Celecoxib is superior to diclofenac sodium in the treatment of KOA. However, well-designed and high-quality RCTs are still needed.

Discipline Area Score
Physician 5 / 7
Comments from MORE raters

Physician rater

I believe most of us know that celecoxib and diclofenac are beneficial. The driver to pick celecoxib is usually GI-tolerance issues. Not sure whether this adds significantly to our knowledge about these 2 NSAIDs.

Physician rater

There are some concerns about the generalizability of this meta-analysis. First, the drug dosing is not reported. Second, the lack of broader representation of international studies. Third, the differences in the measurement methods.
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