Comparative Safety and Cost Effective Analysis between Aceclofenac, Lornoxicam and Diclofenac in Patients of Musculo Skeletal Disorder

Newer NSAIDs like Aceclofenac and Lornoxicam are being marketed by pharmaceutical industries with claims of better efficacy and safety than conventional NSAIDs like Diclofenac. So this study aims to comparatively assess the safety, efficacy and cost of Aceclofenac, Lornoxicam and Diclofenac in patients of musculoskeletal disorders. Patients presenting with musculoskeletal disorders were randomized into three treatment groups (50 in each). Comparative analgesic efficacy assessment between the three drugs were done by using visual analog scale (VAS) reading on Day-0 and then weekly till 3 weeks; adverse drug reaction (ADR) information were collected by spontaneous reporting from patients and by active surveillance and were recorded in a predesigned proforma. Relative cost was assessed by comparative unit cost price of individual drugs (of different pharmaceutical companies). It was observed that Lornoxicam, Aceclofenac and Diclofenac are equally effective as analgesic. Both Aceclofenac and Lornoxicam have similar ADR profile which is significantly less than that of Diclofenac. Though analgesic activity and safety profile of Aceclofenac is comparable to Lornoxicam, but Aceclofenac is cheaper than Lornoxicam , hence comparatively cost effective. INTRODUCTION: Non steroidal anti-inflammatory drugs (NSAIDs) are widely used in patients suffering from musculoskeletal disorders. The conventional NSAIDs which inhibit both COX-1 and COX-2 have high incidence of gastrointestinal adverse effects. Selective COX-2 inhibitors like Rofecoxib, Valdecoxib, etc were introduced with claims of better GI safety. But Rofecoxib was withdrawn from market due to higher incidence of serious thromboembolic events (Bersa Lier et al., 2005) 1 & Valdecoxib has higher incidence of toxic epidermal necrolysis. Recently newer NSAIDs like Aceclofenac and Lornoxicam are being marketed by various Pharmaceutical industries with claims of better efficacy and safety than conventional NSAIDs like Diclofenac and Piroxicam , on the basis of cox -1 sparing & preferential COX 2 inhibition potential with Aceclofenac (Hinz B. et al) 2 and better synovial fluid penetrability of lornoxicam (Skjodt. N et al) . Though there is some data regarding comparison of Aceclofenac with Diclofenac & lornoxicam with Diclofenac, but there is no comparative data between Aceclofenac & Lornoxicam or regarding the cost effectiveness among these three drugs. So the aim of our study was to make a comparative assessment regarding the safety, efficacy and cost between Aceclofenac, Lornoxicam and Diclofenac. Correspondence to Author: