Individual Medication Effectiveness Tests Comparing Celecoxib (encapsulated Celebrex) with Panadol Extend for Relief of Osteoarthritis.

This single patient (n of 1) Individualised Medication Effectiveness Test (IMET) is a randomised, double-blind, cross-over comparison of celecoxib (200mg ro 400mg daily) and Panadol Extend (3990mg paracetamol daily) within an individual patient. The patient will undergo three pairs of treatment periods. The duration of each treatment period will be two weeks (so each pair will be four weeks), making a total of twelve weeks. During one period of each pair the patient will take celecoxib and a Panadol Extend placebo, and during the other period they will take Panadol Extend and a celecoxib placebo. The order of drugs in each cycle will be determined by random allocation. The choice of initial therapy will be balanced in blocks of four, to ensure that equivalent numbers start the IMET on each of the two drugs. Patient and practitioners will be blinded to which treatment the patients are taking. The patient will keep careful track of their symptoms by recording them in a special diary. If at any time during the patient feels worse, that treatment period can be terminated, and they can go on to the next treatment period. Upon the completion of the study, the timing of each active treatment will be revealed. After looking at the symptom scores recorded on the patient's report and the analysis provided by the IMET Service, the doctor and patient decide together which drug is of greatest benefit. If the patient chooses, they can then continue on that drug, confident that it is the most effective.