Lumiracoxib in the management of osteoarthritis and acute pain

Lumiracoxib is a highly selective COX-2 inhibitor with a novel chemical structure and a relatively short plasma half-life. It has been approved in > 40 countries for the symptomatic treatment of osteoarthritis and/or acute pain related to primary dysmenorrhoea and dental or orthopaedic surgery. In these conditions, lumiracoxib has proved to be as effective as standard doses of conventional NSAIDs and other COX-2 selective inhibitors (coxibs). According to the Therapeutic Arthritis Research Gastrointestinal Trial, which enrolled 18,325 patients with osteoarthritis, lumiracoxib 400 mg/day (four times its recommended dosage) was associated with a significant decrease in the risk of ulcer complications compared with naproxen 1000 mg/day and ibuprofen 2400 mg/day, at least in the population not taking low-dose aspirin. The atherothrombotic potential of NSAIDs, especially coxibs, has been much debated. In this respect, available data do not suggest that lumiracoxib may be associated with an increased hazard of cardiovascular events compared with non-selective NSAIDs. Finally, lumiracoxib may be an effective and safe drug provided both physicians and patients will comply with its approved indications and contraindications.