Etoricoxib in the 21st Century: An Old Molecule With New Possibilities

Chronic pain conditions, including osteoarthritis (OA), rheumatoid arthritis (RA), ankylosing spondylitis (AS), and acute gouty arthritis (AGA) are responsible for a substantial proportion of global disabilities and healthcare burdens. Etoricoxib, a selective cyclooxygenase-2 (COX) inhibitor, has shown better efficacy in these conditions due to its anti-inflammatory and analgesic properties. Its pharmacokinetic properties allow for rapid absorption and a long half-life, the latter enabling once-daily dosing, which has the impact of enhancing both adherence and symptom relief. Recent pharmacological investigations have evidenced the efficacy of etoricoxib intervention in other indications such as dental pain, low back pain (LBP), and postoperative analgesia. Clinical trials and meta-analyses have revealed etoricoxib’s superiority over traditional non-steroidal anti- inflammatory drugs (NSAIDs) such as ibuprofen. Novel delivery systems such as nanostructured lipid carriers have been shown to have improved anti-inflammatory effects and decreased cardiotoxicity in preclinical studies. Etoricoxib has shown synergistic outcomes when etoricoxib is combined with tramadol, pregabalin, or thiocolchicoside in the treatment of both acute as well as chronic musculoskeletal pain. This article assembles the latest therapeutic advances and clinical and safety information on etoricoxib, highlighting its emerging role as an important drug in personalized management of pain and inflammation