Evidence map›Paper›PMID 18384679›Full record

ArticleArthritis research & therapy2008

Numbers needed to treat calculated from responder rates give a better indication of efficacy in osteoarthritis trials than mean pain scores.

R Andrew Moore, Owen A Moore, Sheena Derry, Henry J McQuay

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Arthritis research & therapy, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01619150 (A Single Center, Randomized, Double-blind, Placebo-controlled 2-way Crossover Study to Investigate the Mechanism of Action of Etoricoxib in Subjects With Osteoarthritis Knee Pain.), which is not on this map. Cited by 21 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 8 pooled it
2.9field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01619150 phase2completednot on this mapstarted 2012, after this paper: background citation

A Single Center, Randomized, Double-blind, Placebo-controlled 2-way Crossover Study to Investigate the Mechanism of Action of Etoricoxib in Subjects With Osteoarthritis Knee Pain.

TypeinterventionalSponsorC4PainRan2012 to 2013Enrolled39ConditionsOsteoarthritisArmsEtoricoxib, followed by placebo (matching tablet, without active ingredient), Placebo (matching tablet, without active ingredient), followed by etoricoxib
3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 8 syntheses or guidelines pooled it, 40 citations in OpenAlex.

  1. Pooled it
  2. Vitamin D for the treatment of chronic painful conditions in adults.The Cochrane database of systematic reviews · 2015
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  5. Vitamin D for the treatment of chronic painful conditions in adults.The Cochrane database of systematic reviews · 2010
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

R Andrew MoorePain Research and Nuffield Department of Anaesthetics, University of Oxford, Oxford Radcliffe Hospital, Oxford OX3 7LJ, UK. andrew.moore@pru.ox.ac.uk
Owen A Moore
Sheena Derry
Henry J McQuay
University of Oxford · GBJohn Radcliffe Hospital · GBMusgrove Park Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionOsteoarthritis trials usually report average changes in visual analogue scale (VAS) pain, and examine the difference between treatment and placebo. We investigated whether dichotomous responder analysis provides a more informative interpretation of drug efficacy.

methodsMerck supplied the number of patients who, by 6 weeks, had achieved pain relief compared with a baseline of 0% or more, 10% or more, 20% or more, and so on at equal intervals up to 90% or more. These different levels of pain relief were used to distinguish different definitions of responders, for example at least 50% pain relief from baseline. Numbers and percentages of patients achieving each level were identified. Information was sought from a dose-response trial over 6 weeks in osteoarthritis using placebo and using etoricoxib at 5, 10, 30 and 60 mg daily.

resultsWith placebo, the proportions of patients achieving at least 20%, 50% and 70% pain relief over baseline at 6 weeks were 30%, 11% and 2%. With 60 mg etoricoxib the equivalent percentages were 74%, 49% and 29%. The numbers needed to treat for 30 mg and 60 mg etoricoxib to produce at least 50% pain relief at 6 weeks compared with placebo were 4.2 (95% confidence interval 3.8 to 8.6) and 2.6 (2.0 to 3.9), respectively. Levels of pain relief of 50% and above discriminated best between different doses of etoricoxib.

conclusionResponder analysis seemed to be more sensitive than examination of average changes in VAS pain scores. Validation would require calculations to be performed on a set of trials using individual patient data not available in publications.

Indexed as

Randomized Controlled Trials as TopicResearch DesignAdultAgedAged, 80 and overCyclooxygenase InhibitorsDose-Response Relationship, DrugDouble-Blind MethodEtoricoxibFemaleHumansMaleMiddle AgedOsteoarthritisPainPain MeasurementCyclooxygenase InhibitorsEtoricoxibPyridinesSulfones

Identifiers

PMID18384679
PMCPMC2453757
OpenAlexW2097719036

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.