Intravenous meloxicam linked to decreased opioid use after orthopedic surgery

  • J Pain Res

  • Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • Patients undergoing orthopedic surgery who received IV meloxicam needed significantly fewer opioids than those receiving a placebo, with a similar adverse event (AE) profile.

Why this matters

  • Prior studies found that IV meloxicam yielded significantly greater pain relief than placebo.

Study design

  • Post hoc subgroup analysis of a phase 3 multicenter, randomized, double-blind, placebo-controlled trial that assessed the safety of meloxicam IV in 379 adults undergoing major surgery.
  • Treatment groups: IV meloxicam 30 mg or placebo administered as bolus injection every 24 hours.
  • Funding: Baudax Bio (formerly Recro Pharma, Inc.).

Key results

  • AEs were mild/moderate in both treatment groups.
  • Similar adverse events were reported in the meloxicam IV group and the placebo group:
    • ≥1 AE was reported in 64.7% of patients in the meloxicam group and 68.8% of the placebo group.
  • Serious AEs occurred in 2.5% of patients in the meloxicam group and 4.2% of the placebo group.
  • Total opioid consumption was significantly lower in the meloxicam IV group vs the placebo group:
    •  36.8 vs 50.3 mg IV morphine equivalent dose (P=.0081).
  • Opioid consumption during times 0-24 (P=.0032), 24-48 (P=.0362), 0-48 (P=.0032), and 0-72 (P=.0037) hours was significantly lower in the meloxicam IV group.

Limitations

  • Subgroup analysis underpowered.

Coauthored with Chitra Ravi, MPharm