NSAIDs of limited benefit in osteoarthritis
Non-steroidal anti-inflammatory drugs (NSAIDs) are only slightly better than placebo at reducing the pain of knee osteoarthritis over the short term.
This is the conclusion of researchers from Norway who analysed 23 trials
involving 10,845 patients. The researchers point out that current guidelines
recommend the use of oral NSAIDs as second-line therapy, after paracetamol,
in the treatment of knee osteoarthritis. However, they say that NSAIDs
are used regularly by half of all patients with this condition.
The current research reveals that the advantage of oral NSAIDs over placebo
for short-term pain relief is small — using a visual analogue scale,
the pooled difference for pain was 10.1mm (95 per cent confidence interval
7.4 to 12.8) or 15.6 per cent better than placebo after two to 13 weeks.
Earlier research suggests that pain associated with knee osteoarthritris
needs to be reduced by 17 to 22 per cent to be considered meaningful.
“As use of oral NSAIDs may incur serious adverse effects, they
can only be recommended for limited use in osteoarthritis of the knee,” the
researchers conclude (published on BMJ
Online First).
Acupuncture Using acupuncture in addition to diclofenac to treat
osteoarthritis of the knee reduces pain and stiffness more than drug
treatment alone. Researchers compared use of acupuncture with a placebo
technique in 88 patients who all received diclofenac (50mg every
eight hours). After 12 weeks patients who received acupuncture had
improved pain, stiffness and physical function (BMJ 2004;329:1216).
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