Treatment compliance and safety of aceclofenac versus standard NSAIDs in patients with common arthritic disorders : A meta-analysis

Objective: To compare the treatment compliance and safety of aceclofenac (AC) with diclofenac (DC), indomethacin (IND), naproxen (NX), piroxicam (PX), tenoxicam (TX) and ketoprofen (KP) in the treatment of osteoarthritis (OA), rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Methods: The studies were selected on the basis of predetermined inclusion criteria. Thirteen studies, comprising 3,574 patients, met the eligibility criteria. Treatment compliance was measured by the number of patients who completed the full treatment period. Safety was assessed by four criteria: (1) number of patients without adverse events, (2) number of patients without gastrointestinal adverse events, (3) withdrawals due to adverse events, and (4) withdrawals due to gastrointestinal adverse events. Results: Overall, patients treated with AC showed significantly better compliance than patients treated with comparator NSAIDs. In OA and RA, AC showed a significantly better compliance profile than comparator drugs. There was no significant difference in treatment compliance in AS. The number of patients without adverse events and without gastrointestinal adverse events was significantly greater in the AC group. The number of withdrawals due to adverse events and withdrawals due to gastrointestinal adverse events was significantly lower in the AC group. Conclusions: Patients with common arthritic disorders treated with AC have a significantly higher probability of completing treatment than patients treated with other common NSAIDs. Total adverse events and withdrawals due to those events were significantly lower with AC than with comparator NSAIDs. This was also true of specific gastrointestinal adverse events and withdrawals due to those events. Compared to other commonly used NSAIDS, AC exhibits a significantly better safety profile and warrants serious consideration as a drug of choice for the treatment of rheumatic diseases.