Efficacy of celecoxib and diclofenac in the pain management of Rheumatoid Arthritis: A Clinical study

Background: Rheumatoid arthritis(RA) is a systemic auto-immune disorder, involving inflammation of the joints. Non-Steroidal Anti-inflammatory drugs (NSAIDs) are used to reduce the symptoms RA but the Non- Selective NSAIDs such as diclofenac is associated with significant gastro-intestinal side effects including bleeding, ulceration and perforations. NSAIDs like celecoxib which is selective cyclooxygenase (COX) II inhibitor is used widely in order to reduce the GI toxicity. Objectives: To compare the efficacy of celecoxib and diclofenac in the pain management of RA. Methods: 30 RA patients were included in the study. Group A (15 patients) was given celecoxib 100mg twice daily (200mg/day) and Group B(15 patients) was given diclofenac 50mg thrice daily(150mg/day) for 6 weeks. Pain was assessed before the start of medication and at the end of 6 weeks using Visual analogue score (VAS).  Results: Mean age, mean pre-medication VAS scores in both groups was similar. VAS scores were decreased in both groups at the end of 6 weeks, however VAS scale was more less in Group A when compared with Group B. Interpretation and conclusions: Celecoxib is more effective when compared with diclofenac in pain management of Rheumatoid arthritis. Key Words: Rheumatoid Arthritis, Selective COX II inhibitors, NSAIDs, Pain