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Forest plot of comparison: 1 Celecoxib 200 mg versus placebo, outcome: 1.1 At least 50% pain relief over 4‐6 hours.
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Figure 1

Forest plot of comparison: 1 Celecoxib 200 mg versus placebo, outcome: 1.1 At least 50% pain relief over 4‐6 hours.

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Forest plot of comparison: 2 Celecoxib 400 mg versus placebo, outcome: 2.1 At least 50% pain relief over 4‐6 hours dental pain.
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Figure 2

Forest plot of comparison: 2 Celecoxib 400 mg versus placebo, outcome: 2.1 At least 50% pain relief over 4‐6 hours dental pain.

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Forest plot of comparison: 1 Celecoxib 200 mg versus placebo, outcome: 1.2 Use of rescue medication over 24 hours.
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Figure 3

Forest plot of comparison: 1 Celecoxib 200 mg versus placebo, outcome: 1.2 Use of rescue medication over 24 hours.

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Forest plot of comparison: 2 Celecoxib 400 mg versus placebo, outcome: 2.2 Use of rescue medication over 24 hours.
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Figure 4

Forest plot of comparison: 2 Celecoxib 400 mg versus placebo, outcome: 2.2 Use of rescue medication over 24 hours.

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Comparison 1 Celecoxib 200 mg versus placebo, Outcome 1 At least 50% pain relief over 4‐6 hours.
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Analysis 1.1

Comparison 1 Celecoxib 200 mg versus placebo, Outcome 1 At least 50% pain relief over 4‐6 hours.

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Comparison 1 Celecoxib 200 mg versus placebo, Outcome 2 Use of rescue medication over 24 hours.
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Analysis 1.2

Comparison 1 Celecoxib 200 mg versus placebo, Outcome 2 Use of rescue medication over 24 hours.

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Comparison 2 Celecoxib 400 mg versus placebo, Outcome 1 At least 50% pain relief over 4‐6 hours, dental pain.
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Analysis 2.1

Comparison 2 Celecoxib 400 mg versus placebo, Outcome 1 At least 50% pain relief over 4‐6 hours, dental pain.

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Comparison 2 Celecoxib 400 mg versus placebo, Outcome 2 Use of rescue medication over 24 hours.
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Analysis 2.2

Comparison 2 Celecoxib 400 mg versus placebo, Outcome 2 Use of rescue medication over 24 hours.

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Table 1. Summary of outcomes: analgesia and rescue medication

Analgesia

Rescue medication

Study ID

Treatment

PI or PR

Number with 50% PR

PGE: v good or excellent

Median time to use (hr)

Number using

Malmstrom 1999

(1) cele 200 mg, n=91

(2) rofe 50 mg, n=90

(3) ibu 400 mg, n=46

(4) placebo, n=45

TOTPAR 6:

(1) 9.55

(4) 3.07

(1) 38/91

(4) 2/45

at 8 hrs:

(1) 26/91

(4) 3/45

(1) 5.1

(4) 1.5

in 24 hrs:

(1) 71/91

(4) 41/45

Gimbel 2001

(1) cele 200 mg, n=141

(2) hydrocod/paracet 10/1000 mg, n=136

(3) placebo, n=141

SPID 6:

(1) 4.38

(3) 2.51

(1) 55/141

(3) 30/141

no data

(1) >8

(3) 3.9

at 8 hrs:

(1) 62/141

(3) 90/141

Malmstrom 2002

(1) cele 400 mg, n=151

(2) cele 200 mg, n=90

(3) rofe 50 mg, n=150

(4) ibu 400 mg, n=45

(5) placebo, n=45

TOTPAR 6:

(1) 10.98

(2) 8.4

(5) 1.04

(1) 74/151

(2) 32/90

(5) 0/45

at 8 hrs:

(1) 62/151

(2) 31/90

(5) 1/45

pts did not report ‐ assume poor response

(1) 10.6

(2) 6.8

(5) 1.6

at 24 hrs:

(1) 99/151

(2) 62/90

(5) 44/45

Kellstein 2004

(1) cele 200 mg, n=101

(2) lumira 400 mg, n=101

(3) rofe 50 mg, n=102

(4) placebo, n=51

TOTPAR 6:

(1) 6.13

(4) 1.4

(1) 23/101

(4) 0/51

no usable data

(1) 2.0

(4) 1.3

14.9% of whole group

Moberly 2007

(1) cele 400 mg, n=51

(2) placebo, n=52

Also tested: CS‐706 at 10, 50, 100, 200 mg

TOTPAR 4:

(1) 7.2

(2) 2.4

(1) 25/51

(2) 4/51

at 24 hrs:

(1) 49%

(2) 14%

(1) >12

(2) 1.67

at 6 hrs:

(1) 12/51

(2) 41/51

Doyle 2002

(1) cele 200 mg, n=74

(2) ibu liquigel 400 mg, n=74

(3) placebo, n=26

no usable data

no data

no usable data

(1) >12

(3) 2.0

at 12 hrs:

(1) 30/74

(3) 21/26

Cheung 2007

(1) cele 400 mg, n=57

(2) ibu 400 mg, n=57

(3) placebo, n=57

TOTPAR 6:

(1) 13.4

(3) 3.7

(1) 36/57

(3) 5/57

no data

(1) >24

(3) 1.85

at 24 hrs:

(1) 26/57

(3) 49/57

Fricke 2008

(1) cele 400 mg, n=156

(2) lumira 400 mg, n=156

(3) placebo, n=52

TOTPAR 6:

(1) 7.78

(3) 1.76

(1) 49/156

(3) 0/52

no usable data

(1) 3.8

(3) 1.3

at 24 hrs:

(1) 103/156

(3) 47/52

PI ‐ pain intensity; PR ‐ pain relief; cele ‐ celecoxib; rofe ‐ rofecoxib; lumira ‐ lumiracoxib; ibu ‐ ibuprofen; hydocod/paracet ‐ hydrocodone/paracetamol

Figuras y tablas -
Table 1. Summary of outcomes: analgesia and rescue medication
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Table 2. Summary of outcomes: adverse events and withdrawals

Adverse events

Withdrawals

Study ID

Treatment

Any

Serious

Adverse event

Other

Malmstrom 1999

(1) cele 200 mg, n=91

(2) rofe 50 mg, n=90

(3) ibu 400 mg, n=46

(4) placebo, n=45

no useable data

Mostly nausea, vomiting, headache

none reported

(1) 0/91

(4) 1/45 (excessive bleeding)

none

Gimbel 2001

(1) cele 200 mg, n=141

(2) hydrocod/paracet 10/1000 mg, n=136

(3) placebo, n=141

to 8 hrs:

(1) 16/141

(3) 20/141

Mostly nausea, vomiting, somnolence, headache

none reported

(1) 1/141

(3) 0/141

none

Malmstrom 2002

(1) cele 400 mg, n=151

(2) cele 200 mg, n=90

(3) rofe 50 mg, n=150

(4) ibu 400 mg, n=45

(5) placebo, n=45

to 24 hrs:

(1) 38/151

(2) 22/90

(5) 12/45

Mostly nausea and vomiting

(1) 0/151

(2) 1/90 (at post study visit, not related to medication)

(5) 0/45

none reported

none

Kellstein 2004

(1) cele 200 mg, n=101

(2) lumira 400 mg, n=101

(3) rofe 50 mg, n=102

(4) placebo, n=51

to 24 hrs:

(1) 20/101

(4) 9/51

none

none

none

Moberly 2007

(1) cele 400 mg, n=51

(2) placebo, n=52

Also tested CS‐706 at 10, 50, 100, 200 mg

to 24 hrs:

(1) 23/51

(2) 27/52

drug related:(1) 5/51; (2) 13/52

none

none

I placebo pt had protocol violation (rescue medication early) ‐ excl from ITT analysis

Doyle 2002

(1) cele 200 mg, n=74

(2) ibu liquigel 400 mg, n=74

(3) placebo, n=26

to 12 hrs:

(1) 5/74

(3) 3/26

Most mild to moderate, nausea, vomiting, headache

none

(1) 0/74

(3) 0/26

5 pts (2 cele) excl from analysis due to protocol violation, admin reason, withdrew consent

Cheung 2007

(1) cele 400 mg, n=57

(2) ibu 400 mg, n=57

(3) placebo, n=57

to 24 hrs:

(1) 29/57

(3) 39/57

(1) 1/57 (rhabdomyolysis)

(3) 0/57

(1) 1/57

(3) 3/57

1 placebo pt withdrew consent

Fricke 2008

(1) cele 400 mg, n=156

(2) lumira 400 mg, n=156

(3) placebo, n=52

to 24 hrs:

(1) 17/156

(3) 9/52

none

none

none

cele ‐ celecoxib; rofe ‐ rofecoxib; lumira ‐ lumiracoxib; ibu ‐ ibuprofen; hydocod/paracet ‐ hydrocodone/paracetamol; ITT ‐ intention to treat

Figuras y tablas -
Table 2. Summary of outcomes: adverse events and withdrawals
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Comparison 1. Celecoxib 200 mg versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 At least 50% pain relief over 4‐6 hours Show forest plot

4

705

Risk Ratio (M‐H, Fixed, 95% CI)

3.49 [2.40, 5.06]

1.1 Dental pain

3

423

Risk Ratio (M‐H, Fixed, 95% CI)

15.86 [5.14, 48.99]

1.2 Postsurgical pain

1

282

Risk Ratio (M‐H, Fixed, 95% CI)

1.83 [1.26, 2.68]

2 Use of rescue medication over 24 hours Show forest plot

2

271

Risk Ratio (IV, Fixed, 95% CI)

0.78 [0.70, 0.86]
Figuras y tablas -
Comparison 1. Celecoxib 200 mg versus placebo
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Comparison 2. Celecoxib 400 mg versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 At least 50% pain relief over 4‐6 hours, dental pain Show forest plot

4

620

Risk Ratio (M‐H, Fixed, 95% CI)

11.47 [5.85, 22.49]

2 Use of rescue medication over 24 hours Show forest plot

3

518

Risk Ratio (IV, Fixed, 95% CI)

0.68 [0.62, 0.74]
Figuras y tablas -
Comparison 2. Celecoxib 400 mg versus placebo
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