Non-steroidal anti-inflammatory drugs, including cyclo-oxygenase-2 inhibitors, in osteoarthritic knee pain: meta-analysis of randomised placebo controlled trials

摘要: Abstract Objective To estimate the analgesic efficacy of non-steroidal anti-inflammatory drugs (NSAIDs), including selective cyclo-oxygenase-2 inhibitors (coxibs), in patients with osteoarthritis knee. Design Systematic review and meta-analysis randomised placebo controlled trials. Studies reviewed 23 trials 10 845 patients, median age 62.5 years. 7807 received adequate doses NSAIDs 3038 placebo. The mean weighted baseline pain score was 64.2 mm on 100 visual analogue scale (VAS), average duration symptoms 8.2 Main outcome measure Change overall intensity pain. Results Methodological quality acceptable, but 13 excluded before randomisation if they did not respond to NSAIDs. One trial provided long term data for that showed no significant effect compared at one four pooled difference all included 10.1 (95% confidence interval 7.4 12.8) or 15.6% better than after 2-13 weeks. results were heterogeneous, size reduction 0.32 (0.24 0.39) a random effects model. In exclude non-responders NSAID treatment homogeneous, an 0.23 (0.15 0.31). Conclusion can reduce short knee slightly placebo, current analysis does support use this condition. As serious adverse are associated oral NSAIDs, only limited be recommended.