Discontinuation Rates in Clinical Trials of Musculoskeletal Pain
Author Information
Author(s): Andrew Moore, Sheena Derry, Henry J McQuay
Primary Institution: University of Oxford
Hypothesis
Discontinuation rates would differ between osteoarthritis, rheumatoid arthritis, and other musculoskeletal conditions for lack of efficacy, but probably not because of adverse events.
Conclusion
Discontinuation data from clinical trials does not necessarily predict real-world clinical effectiveness, which may differ from clinical efficacy assessed in trials.
Supporting Evidence
- Discontinuation rates due to lack of efficacy were significantly lower with etoricoxib compared to placebo.
- Adverse event discontinuations were similar between etoricoxib and placebo.
- Etoricoxib had fewer discontinuations than NSAIDs for lack of efficacy and clinical adverse events.
Takeaway
This study looked at how often patients stop taking pain medication in trials, finding that many stop because the medicine doesn't work or causes side effects.
Methodology
The study analyzed data from 18 randomized trials of etoricoxib in musculoskeletal conditions, examining discontinuation rates due to lack of efficacy and adverse events.
Potential Biases
Potential bias due to selective reporting in published papers.
Limitations
The study relies on clinical trial reports, which may not fully represent real-world scenarios.
Participant Demographics
The majority of participants were women, with a mean age over 60 in osteoarthritis and rheumatoid arthritis trials, and about 50 years in low back pain trials.
Digital Object Identifier (DOI)
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