DOI
https://doi.org/10.18849/ve.v5i3.288Abstract
PICO question
In dogs diagnosed with osteoarthritis, is meloxicam superior to carprofen for reducing patient discomfort?
Clinical bottom line
Category of research question
Treatment
The number and type of study designs reviewed
Only two papers have compared the efficacy between meloxicam and carprofen in the treatment of dogs diagnosed with osteoarthritis. Both of the papers were clinical, prospective and randomised trials.
Strength of evidence
Weak
Outcomes reported
One randomised controlled clinical trial compared the level of efficacy between meloxicam and carprofen in reducing pain and discomfort in dogs diagnosed with osteoarthritis1. Orthopaedic surgeons found dogs treated with either meloxicam or carprofen showed significant improvement in ground reaction forces (GRF). The study emphasised that dogs treated with meloxicam had GRF values that returned to normal baseline values, with owners also commenting on gait improvement. This study however, had a low sample size, did not use a validated metrology instrument for assessment by owners and the data used to assess GRF was not conclusive on all parameters to favour meloxicam.
An additional study was evaluated but this also had very small case numbers, no control group and gave no detailed statistical analysis2. The paper descriptively suggests meloxicam to show a better response than carprofen but there was no scientific analysis or evidence to statistically support and validate this.
Conclusion
Both meloxicam and carprofen are validated as effective treatments for canine osteoarthritis but it cannot be suggested that meloxicam is superior to carprofen as the available evidence is weak. To accurately assess this, a future clinical study using validated metrology instruments, adequate sample sizes and proper statistical analysis is required.
How to apply this evidence in practice
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision-making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
References
Moreau, M., Dupuis, J., Bonneau, N. H. & Desnoyers, M. (2003). Clinical evaluation of a nutraceutical, carprofen and meloxicam for the treatment of dogs with osteoarthritis. Veterinary Record, 152(11): 323–329. DOI: http://dx.doi.org/10.1136/vr.152.11.323
Mariana, G., Valentin, N., Raluca, M. & Hritcu, D-L. (2013). Comparative evaluation on the efficiency and tolerability of three NSAIDs used in locomotive osteoarticular inflammations in dog. Scholars Journals of Agriculture and Veterinary Sciences. 56: 274–282.
Choy, L. T. (2014). The Strengths and Weaknesses of Research Methodology: Comparison and Complimentary between Qualitative and Quantitative Approaches. Journal of HumanIties and SocIal Science, 19(4): 99–104. DOI: http://dx.doi.org/9790/0837-194399104
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Juni, P., Altman, D.G. & Egger, M. (2001). Assessing the quality of controlled clinical trials. BMJ, 323: 42–46. DOI: https://doi.org/10.1136/bmj.323.7303.42
Barkan, H. (2015). Statistics in clinical research: Important considerations. Annals of Cardiac Anaesthesia, 18(1): 74–82. DOI: http://dx.doi.org/10.4103/0971-9784.148325
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Anderson, M. A. & Mann, F. A. (1994). Force plate analysis: a non-invasive tool for gait evaluation. Compendium on Continuing Education for the Practicing Veterinarian, 16: 857-866.
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Hussein, A. (2009). The Use of Triangulation in Social Sciences Research: Can qualitative and quantitative methods be combined? Journal of Social Work Practice, 01–12.
Monteiro-Steagall, B. P., Steagall P. M. V. & Lascelles, B. D. X. (2013). Systemic Review of Nonsteroidal Anti-Inflammatory Drug-Induced Adverse Effects in Dogs. Journal of Veterinary Internal Medicine, 27(5): 1011–1019. DOI: http://doi.org/10.1111/jvim.12127
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