A Parallel-Group Comparison Study of Celecoxib With Loxoprofen Sodium in Wisdom Tooth Extraction Patients

Yamashita, Yoshio

A Parallel-Group Comparison Study of Celecoxib With Loxoprofen Sodium in Wisdom Tooth Extraction Patients

Yoshio Yamashita DDS, PhD, Department of Oral and Maxillofacial Surgery, Saga University, Faculty of Medicine, Saga, Japan

Naoto Sano PhD, Department of Oral and Maxillofacial Surgery, Saga University, Faculty of Medicine, Saga, Japan

Reona Aijima , Department of Oral and Maxillofacial Surgery, Saga University, Faculty of Medicine, Saga, Japan

Daiji Shimohira PhD, Department of Oral and Maxillofacial Surgery, Saga University, Faculty of Medicine, Saga, Japan

Atsushi Danjo , Department of Oral and Maxillofacial Surgery, Saga University, Faculty of Medicine, Saga, Japan

Masaaki Goto , Department of Oral and Maxillofacial Surgery, Saga University, Faculty of Medicine, Saga, Japan

Celecoxib, a selective COX-2 inhibitor, is used to treat chronic pain from rheumatoid arthritis or osteoarthritis, and there are hopes that it may be also be useful for acute pain following surgery, trauma, or tooth extraction.

Wisdom tooth extraction is the most common oral surgical procedure. A number of different NSAIDs are currently used for post-extraction analgesia, but since most of these are non-selective COX inhibitors, they entail the risk of gastrointestinal damage, including gastrointestinal ulcers, perforation, obstruction, and hemorrhage.

In this study, patients who had undergone wisdom tooth extraction were given either loxoprofen sodium, the NSAID most frequently used in Japan for this purpose, or the selective COX-2 inhibitor celecoxib, and their efficacy and safety were compared.

This was a parallel-group comparison study, in which 107 patients who had undergone wisdom tooth extraction were given celecoxib, and 102 were given loxoprofen.

The level of pain on a visual analogue scale (VAS) 15 min and 30 min after taking the experimental drug decreased with the passage of time, with no significant difference between the two groups. The percentage of patients taking a second dose was 64.5% for celecoxib and 80.4% for loxoprofen. The time to second dose was significantly longer for celecoxib (533.5 min) than for loxoprofen (387.4 min). There was no significant difference in efficacy between the two groups in terms of patient’s impression of efficacy, at 77.4% for loxoprofen and 74.5% for celecoxib.

These results demonstrated that celecoxib is not inferior to loxoprofen for pain after wisdom tooth extraction, and that its effect is actually more persistent.