Nationwide Etoricoxib Injection Clinical Experience (NICE) 2.0: Assessing Real-World Effectiveness and Tolerability of Etoricoxib Injection in Acute Pain Management in Both Inpatient and Outpatient Settings

Background: Effective acute pain management remains a challenge. Etoricoxib, a selective COX-2 inhibitor, is known for its favorable safety profile compared to traditional NSAIDs. While oral etoricoxib is well-established for pain management, the intramuscular (IM) formulation remains underrepresented in the published literature and warrants further clinical investigation. Objectives: This study aims to assess the effectiveness of IM etoricoxib (90 mg/mL) in reducing acute pain severity in inpatient and outpatient settings and to evaluate its tolerability. Materials and methods: In this retrospective, multicenter, observational cohort study, medical records of 1,018 patients treated at the discretion of doctors across 296 centers in India were reviewed. Pain was assessed on the 10-point Visual Analog Scale (VAS). In outpatient settings, VAS score recordings were taken at baseline and at 30- and 60-minute post-injection intervals. In inpatient settings, recordings were taken at baseline, 30 minutes, 60 minutes, 6 hours, 12 hours, and 24 hours. Adverse events were documented. Results: The study included 1,018 patients, 229 (22.5%) inpatients and 789 (77.5%) outpatients. The primary indication for IM etoricoxib injection was acute back pain (272, 26.7%). Pain reduction, measured via VAS, showed significant results. In outpatients, VAS scores reduced by 61.6% at 60 minutes post-injection (p < 0.001). In inpatients, pain reduction was sustained over 24 hours, with a cumulative reduction of 69.45% at 24 hours (p < 0.001). The need for rescue analgesics was minimal (2.9%). Safety analysis revealed no adverse events in 992 (97.4%) of patients, with mild pain at the injection site in 338 (33.2%). Conclusion: IM etoricoxib demonstrated rapid and sustained pain relief with excellent tolerability across diverse patient populations.