Document Detail

A comparison of the efficacy and safety of nonsteroidal antiinflammatory agents versus acetaminophen in the treatment of osteoarthritis: a meta-analysis.
MedLine Citation:
PMID:  15478167     Owner:  NLM     Status:  MEDLINE    
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.
Chin Lee; Walter L Straus; Robert Balshaw; Suna Barlas; Suzanne Vogel; Thomas J Schnitzer
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Publication Detail:
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:
Title:  Arthritis and rheumatism     Volume:  51     ISSN:  0004-3591     ISO Abbreviation:  Arthritis Rheum.     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-10-18     Completed Date:  2005-01-11     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370605     Medline TA:  Arthritis Rheum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  746-54     Citation Subset:  AIM; IM    
Northwestern University, The Feinberg School of Medicine, Chicago, Illinois, USA.
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MeSH Terms
Acetaminophen / therapeutic use*
Analgesics, Non-Narcotic / therapeutic use*
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
Cyclooxygenase Inhibitors / therapeutic use*
Middle Aged
Osteoarthritis, Hip / drug therapy*
Osteoarthritis, Knee / drug therapy*
Treatment Outcome
Grant Support
Reg. No./Substance:
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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