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dc.contributor.authorYelland, Michaelen_US
dc.contributor.authorNikles, C.en_US
dc.contributor.authorMcNairn, N.en_US
dc.contributor.authorDel Mar, C.en_US
dc.contributor.authorSchluter, P.en_US
dc.contributor.authorBrown, R.en_US
dc.contributor.editorR A Wattsen_US
dc.date.accessioned2017-05-03T15:05:58Z
dc.date.available2017-05-03T15:05:58Z
dc.date.issued2007en_US
dc.date.modified2009-05-27T08:41:39Z
dc.identifier.issn14620324en_US
dc.identifier.doi10.1093/rheumatology/kel195en_AU
dc.identifier.urihttp://hdl.handle.net/10072/15035
dc.description.abstractObjective. To assess the use of n-of-1 trials for short-term choice of drugs for osteoarthritis, with particular reference to comparing the efficacy of sustained-release [SR] paracetamol with celecoxib in individual patients. Methods. Evaluation of community-based patients undergoing n-of-1 trials which consisted of double-blind, crossover comparisons of celecoxib 200 or 400 mg/day with sustained-release paracetamol 1330 mg three times a day in three pairs of 2 week treatment periods per drug with random order of the drugs within pairs. Outcomes evaluated were pain and stiffness in sites nominated by the patient, functional limitation scores, preferred medication, side effects and changes in drug use after an n-of-1 trial. Participants were 59 patients with osteoarthritis in multiple sites (hip 6, knee 24, hand 6, shoulder/neck 8, back 14, foot 5), with pain for =1 month severe enough to warrant consideration of long-term use of celecoxib but for whom there was doubt about its efficacy. Forty-one n-of-1 trials were completed. Results. Although on average, celecoxib showed better scores than SR paracetamol [0.2 (0.1) for pain, 0.3 (0.1) for stiffness and 0.3 (0.1) for functional limitation], 33 of the 41 individual patients (80%) failed to identify the differences between SR paracetamol and celecoxib in terms of overall symptom relief. Of the eight patients who were able to identify the differences, seven had better relief with celecoxib and one with SR paracetamol. In 25 out of 41 [61%] patients, subsequent management was consistent with their trial results. Conclusions. N-of-1 trials may provide a rational and effective method to best choose drugs for individuals with osteoarthritis. SR paracetamol is more useful than celecoxib for most patients of whom management is uncertain.en_US
dc.description.peerreviewedYesen_US
dc.description.publicationstatusYesen_AU
dc.format.extent104244 bytes
dc.format.mimetypeapplication/pdf
dc.languageEnglishen_US
dc.language.isoen_AU
dc.publisherOxford University Pressen_US
dc.publisher.placeUnited Kingdomen_US
dc.publisher.urihttp://rheumatology.oxfordjournals.org/en_AU
dc.relation.ispartofstudentpublicationNen_AU
dc.relation.ispartofpagefrom135en_US
dc.relation.ispartofpageto140en_US
dc.relation.ispartofissue1en_US
dc.relation.ispartofjournalRheumatologyen_US
dc.relation.ispartofvolume46en_US
dc.rights.retentionYen_AU
dc.subject.fieldofresearchcode321208en_US
dc.titleCelecoxib compared with sustained-release paracetamol for osteoarthritis: a series of n-of-1 trialsen_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Peer Reviewed (HERDC)en_US
dc.type.codeC - Journal Articlesen_US
gro.facultyGriffith Health, School of Medicineen_US
gro.rights.copyrightCopyright The Author 2006. Published by Oxford University Press on behalf of the British Society for Rheumatology. Please refer to the link for the definitive publisher-authenticated version.en_AU
gro.date.issued2007
gro.hasfulltextFull Text


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