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Rofecoxib vs Celecoxib vs Acetaminophen for Treatment of Osteoarthritis

S. M. A. Bierma-Zeinstra, PhD; A. M. Bohnen, MD, PhD; M. Y. Berger, MD, PhD; S. Thomas, MD, PhD
JAMA. 2002;287(14):1799-1800. doi:10.1001/jama.287.14.1799.
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To the Editor: Dr Geba and colleagues1 reported that rofecoxib, 25 mg/d, was superior to celecoxib, 200 mg/d, and acetaminophen, 4000 mg/d, in treating osteoarthritis (OA) of the knee. We lack important information for supporting this conclusion.

First, it is known that patients are more likely to comply with once-daily regimens2 and that morning doses are less likely to be omitted.3 The report of the trial implied that the cyclooxygenase 2 (COX-2) inhibitors and their placebos were taken once daily, in the morning, while acetaminophen and its placebo were taken 4 times daily. Therefore, it is likely that suboptimal compliance had a large impact on the effect of acetaminophen. It would be helpful to the reader for the authors to report the compliance for the different groups, and to perform a subanalysis for efficacy in highly compliant patients.

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