Efficacy of IV Meloxicam for Bunionectomy-Associated Pain

A once-daily intravenous injection of meloxicam may safely and effectively relieve moderate to severe bunionectomy-associated pain.

A once-daily intravenous (IV) injection of meloxicam may relieve moderate to severe bunionectomy-associated pain safely and effectively, according to a study published in the Clinical Journal of Pain.

For this study, individuals with moderate to severe pain following bunionectomy were randomly assigned to receive once-daily bolus injections of IV 30 mg meloxicam (n=100) or placebo (n=101).

The summed pain intensity difference over a 48-hour period was the study’s primary end point. Safety assessment included evaluation of adverse events and wound healing.

Participants receiving meloxicam vs placebo reported greater pain reductions at 2 hours (least-square mean value, -6956.0±521.69 vs -4829.3±519.56, respectively; P =.0034), 6 hours (-510.78±66.22 vs -288.33±65.95, respectively; P =.0153), 12 hours (-957.83±123.30 vs -480.15±122.80, respectively; P =.0053), 24 hours (-2071.0±247.01 vs -1167.9±246.00, respectively; P =.0084), and 24 to 48 hours (-4885.1±313.60 vs -3661.4±312.32, respectively; P =.0050).

The time to first rescue dose was longer in the meloxicam vs placebo group (P =.0076). Meloxicam administered at 30 mg was well tolerated in the cohort, with no serious adverse events reported during the study. There were a greater number of treatment-emergent adverse events in the placebo vs meloxicam group (total events, 54 vs 44, respectively; mild intensity events, 44 vs 39, respectively; moderate intensity, 21 vs 14, respectively; severe intensity, 6 vs 2, respectively; serious adverse events, 2 vs 0, respectively). The mean wound healing satisfaction scores were comparable for meloxicam and placebo, 48 hours, 7 days, and 28 days after the final treatment.  

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”[Results from this trial] indicate that meloxicam IV may be useful in treating post-bunionectomy pain and may permit a longer dosing interval than is associated with other [nonsteroidal anti-inflammatory drugs] without an increased risk of side effects commonly associated with non-selective [nonsteroidal anti-inflammatory drugs] or opioid analgesics,” concluded the study authors.

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Pollak RA, Gottlieb IJ, Hakakian F, et al. Efficacy and safety of intravenous meloxicam in subjects with moderate-to-severe pain following bunionectomy: A randomized, double-blind, placebo-controlled trial [published online March 16, 2018]. Clin J Pain. doi: 10.1097/AJP.0000000000000609