The anti-oedematous efficacy of oxindanac equals that of paracetamol in acute postoperative inflammation; are weak cyclooxygenase inhibitors more effective than strong inhibitors?

In a double-blind crossover study, the clinical anti-oedematous efficacy was compared of a weak cyclooxygenase inhibitor oxindanac 200 mg thrice daily in a controlled clinical trial procedure with paracetamol 1 g thrice daily as a positive control involving objective measurement of acute soft tissue oedema. Paracetamol is a weak cyclooxygenase inhibitor which reduces acute postoperative tissue oedema by 30% compared to a placebo. There was no significant (p = 0.81) difference between oxindanac and paracetamol with respect to anti-oedematous activity. The present finding is discussed in view of previous results obtained in controlled trials with several other anti-inflammatory drugs, using similar objective methodology as the present one. It is proposed that non-steroidal anti-inflammatory drugs acting solely by strong inhibition of cyclooxygenase need not be optimal anti-oedematous drugs. Reasons for this proposal are discussed.