| A comparison of the efficacy and safety of nonsteroidal antiinflammatory agents versus acetaminophen in the treatment of osteoarthritis: a meta-analysis. | |
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MedLine Citation:
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PMID: 15478167 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To perform a meta-analysis comparing the efficacy and safety of recommended dosages of nonsteroidal antiinflammatory drugs (NSAIDs), including cyclooxygenase 2 inhibitors, versus acetaminophen in the treatment of symptomatic hip and knee osteoarthritis. METHODS: Medline and EMBASE searches were performed for original clinical trials directly comparing NSAIDs with acetaminophen. A standardized form was used to abstract all data, including outcome measures of pain at rest, walking pain, and dropouts due to adverse effects. Inverse-variance-weighted mean differences (WMDs) and 95% confidence intervals (95% CI) for pain measures were determined for treatment groups. Odds ratios (ORs) and 95% CIs were calculated for withdrawals due to adverse events. Results were compared using a random effects model. RESULTS: Seven articles met inclusion criteria with sufficient data for analysis. Participants had a mean age of 61.1 years and 71.1% were women. Test of heterogeneity was not significant for either rest (P = 0.73) or walking (P = 0.76) pain. The scores for overall pain at rest (WMD -6.33 mm on a 100-mm visual analog scale [VAS], 95% CI -9.24, -3.41) and walking pain (WMD -5.76 mm on a 100-mm VAS, 95% CI -8.99, -2.52) favored the NSAID-treated group. Although NSAIDs elevated the risk of withdrawals due to adverse events, the difference was not statistically significant (OR 1.45, 95% CI 0.93, 2.27). CONCLUSION: NSAIDs are statistically superior in reducing rest and walking pain compared with acetaminophen for symptomatic osteoarthritis. Safety, measured by discontinuation due to adverse events, was not statistically different between NSAID- and acetaminophen-treated groups. |
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Authors:
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Chin Lee; Walter L Straus; Robert Balshaw; Suna Barlas; Suzanne Vogel; Thomas J Schnitzer |
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Publication Detail:
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Type: Comparative Study; Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Arthritis and rheumatism Volume: 51 ISSN: 0004-3591 ISO Abbreviation: Arthritis Rheum. Publication Date: 2004 Oct |
Date Detail:
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Created Date: 2004-10-18 Completed Date: 2005-01-11 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0370605 Medline TA: Arthritis Rheum Country: United States |
Other Details:
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Languages: eng Pagination: 746-54 Citation Subset: AIM; IM |
Affiliation:
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Northwestern University, The Feinberg School of Medicine, Chicago, Illinois, USA. c-lee17@northwestern.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acetaminophen
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therapeutic use* Analgesics, Non-Narcotic / therapeutic use* Anti-Inflammatory Agents, Non-Steroidal / therapeutic use* Cyclooxygenase Inhibitors / therapeutic use* Female Humans Male Middle Aged Osteoarthritis, Hip / drug therapy* Osteoarthritis, Knee / drug therapy* Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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T32-AR-07611/AR/NIAMS NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Analgesics, Non-Narcotic; 0/Anti-Inflammatory Agents, Non-Steroidal; 0/Cyclooxygenase Inhibitors; 103-90-2/Acetaminophen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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