Is Robenacoxib Superior to Meloxicam in Improving Patient Comfort in Dogs Diagnosed With a Degenerative Joint Process?

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Appraisal, application and reflection

Whilst only a single relevant paper was available for review, the study did directly compare the two drugs under identical conditions allowing a good assessment of clinical efficacy to be made between them. However, whilst the study did look at and compare many variables relating to meloxicam and robenacoxib no power calculation was demonstrated. One cannot help but be wary of the advanced statistics presented in this study given there were only eight dogs in the study. Also, this study was conducted by authors working for Novartis; the company producing the commercial brand of robenacoxib (Onsior). Finally, whilst experimental conditions were well matched, only efficacy in the acute stages of a joint inflammation were assessed. The study does not asses efficacy in naturally occurring disease and so there could be other factors (such as central sensitisation and patient physical abnormalities such as joint incongruity) affecting the perceived efficacy of the different products in the “real world”which were not considered here. Overall however this study would be useful when considered in the general practice situation as the two products have been compared directly and useful efficacy data has come from it. This usefulness would likely be reduced though should similar studies using patients with naturally occurring disease be available for review. When searching the literature, papers in which meloxicam and robenacoxib were not directly compared were excluded. Whilst these studies provided evidence of efficacy for both meloxicam and robenacoxib individually, they did not provide evidence for which drug would be more effective in the clinical setting and so would not suitably address the clinical question. Ideally larger studies are needed with power calculations to validate these results in patients with naturally occurring disease. Should sufficient data be available, a meta-analysis may also provide valuable data with regards to the clinical question posed. Given the prevalence of degenerative disease seen in practice, there would certainly be an appetite for such research.

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