Prospective Real-World Assessment of Pain Relief with Injection-Based Delivery of Etoricoxib (RAPID Study)

Abstract

Acute pain is frequently inadequately controlled in routine clinical practice, particularly when oral analgesic administration is delayed or impractical. Intramuscular (IM) etoricoxib offers a parenteral option for rapid pain control; however, prospective real-world evidence across diverse acute pain conditions remains limited. The primary objective was to evaluate changes in pain intensity using the Numeric Pain Rating Scale (NPRS) from baseline to predefined post-injection timepoints. Secondary objectives included physician global assessment of pain relief and assessment of tolerability based on reported adverse events. The findings are expected to further strengthen the clinical evidence base for intramuscular (IM) etoricoxib and inform its integration into acute pain management pathways in Indian healthcare settings. This multicenter, noncomparative, prospective observational study was conducted across 68 sites in India. Adults with acute painful conditions prescribed Nucoxia® 90 mg IM etoricoxib as part of routine care were enrolled. Pain intensity was assessed using the Numeric Pain Rating Scale (NPRS) at baseline and predefined post-injection timepoints. The primary endpoint was change in NPRS score from baseline to 60 min post-injection. Effectiveness was additionally evaluated using the Global Physician Assessment. Safety outcomes included injection-site reactions and adverse events. A total of 418 patients were included (364 inpatients; 54 outpatients), with a mean age of 46.0 ± 10.9 years; 69.6% (291/418) were male. Low back pain (36.1%) was the most common indication. Among inpatients, mean NPRS scores decreased from 7.6 ± 1.5 at baseline to 3.3 ± 2.3 at 60 min ( p < 0.001), with sustained improvement to 0.3 at 24 h; 88.7% (323/364) were pain free at 24 h. Among outpatients, mean NPRS scores declined from 6.1 ± 1.6 to 0.8 ± 1.5 at 60 min, with 70.4% (38/54) reporting complete pain relief ( p < 0.001). Physicians reported marked or moderate improvement in 82.3% (344/418) of patients. Adverse events were infrequent, reported by 2.5% of patients with available safety data (9/360). IM etoricoxib was associated with rapid and sustained pain reduction and demonstrated a favorable tolerability profile across a range of acute pain conditions in Indian clinical practice.