Strong evidence supports that NSAIDs improve short-term pain, function, or both in patients with symptomatic osteoarthritis of the hip.

Rationale

All efficacy studies included are high quality placebo controlled trials (Schnitzer, et.al., Baerwald, et.al. , Svensson, et.al., Klein, et.al., Makarowski, et.al. , Kivitz et.al ). Some studies also included comparisons to unavailable, experimental and nutriceutical agents (insert references); these agents were not considered for this review.

All studies reported clinical improvements employing standard clinical measuring instruments, including Womac, SF-36, VAS, OARSI and Lequensne scoring; at least two were used in each study. Study duration never exceeded 13 weeks and was the maximum duration considered when “short-term” was referenced in the work group recommendation. The clinically relevant drugs reviewed included Naproxen, Celecoxib, and Diclofenac. No recommendation can thus be made regarding the use of other agents possibly studied prior to the cutoff date of the systematic literature review inclusion criteria (1990). The “percent responders” ranged widely in studies that made specific note. Likely the values of 67%(Schnitzer), 50% Baerwald, 50% Klein, and 30% Kivitz, can be considered prognostic.

  1. Schnitzer,T.J.; Dattani,I.D.; Seriolo,B.; Schneider,H.; Moore,A.; Tseng,L.; Sallstig,P.; Rebuli,R.; Maxwell,T. A 13-week, multicenter, randomized, double-blind study of lumiracoxib in hip osteoarthritis. Clin Rheumatol.; 2011/11: 11
  2. Baerwald,C.; Verdecchia,P.; Duquesroix,B.; Frayssinet,H.; Ferreira,T. Efficacy, safety, and effects on blood pressure of naproxcinod 750 mg twice daily compared with placebo and naproxen 500 mg twice daily in patients with osteoarthritis of the hip: a randomized, double-blind, parallel-group, multicenter study. Arthritis Rheum.; 2010/12: 12
  3. Svensson,O.; Malmenas,M.; Fajutrao,L.; Roos,E.M.; Lohmander,L.S. Greater reduction of knee than hip pain in osteoarthritis treated with naproxen, as evaluated by WOMAC and SF-36. Ann Rheum. Dis; 2006/6: 6
  4. Klein,G.; Kullich,W.; Schnitker,J.; Schwann,H. Efficacy and tolerance of an oral enzyme combination in painful osteoarthritis of the hip. A double-blind, randomised study comparing oral enzymes with non-steroidal anti-inflammatory drugs. Clin Exp.Rheumatol.; 2006/1: 1
  5. Kivitz,A.J.; Moskowitz,R.W.; Woods,E.; Hubbard,R.C.; Verburg,K.M.; Lefkowith,J.B.; Geis,G.S. Comparative efficacy and safety of celecoxib and naproxen in the treatment of osteoarthritis of the hip. J Int Med Res; 2001/11: 6
  6. Makarowski,W.; Zhao,W.W.; Bevirt,T.; Recker,D.P. Efficacy and safety of the COX-2 specific inhibitor valdecoxib in the management of osteoarthritis of the hip: a randomized, double-blind, placebo-controlled comparison with naproxen. Osteoarthritis Cartilage; 2002/4: 4