BACKGROUND: The efficacy of cyclooxygenase-2 (COX-2) inhibitors, including celecoxib, in managing knee osteoarthritis (KO) is well-established. Recently, the plant extract cocktail JOINS (SKI306X and its newer formulation, SKCPT) has been shown to be an effective slow-acting drug for KO. Aims: To compare the efficacy and safety of celecoxib and JOINS in patients with KO. METHODS: A systematic search of the MEDLINE, Embase, and Cochrane Library databases identified randomized controlled trials (RCTs) assessing the effectiveness and safety of celecoxib and JOINS. The outcomes included pain relief, functional improvement, and safety profiles. Outcome measurements were compared between the celecoxib and JOINS cohorts at the short-term (closest to 3 months) and mid-term (closest to 12 months). RESULTS: Overall, 23 RCTs involving 3367 patients were included in this systematic review. The efficacy of JOINS in reducing pain, as indicated by the visual analog scale (VAS) score, was comparable to that of celecoxib. Regarding functional improvement assessed using the Western Ontario and McMaster University Arthritis Index (WOMAC), JOINS showed improvement comparable to that of celecoxib regardless of follow-up. In addition, no significant difference was observed in the incidence of adverse events between the celecoxib and JOINS cohorts. CONCLUSIONS: The results of this study suggest that JOINS could be considered as a pharmacological agent with significant efficacy for pain relief and functional improvement in patients with KO in clinical practice.
OBJECTIVE: This systematic review with network meta-analysis was performed to compare the effectiveness of oral anti-inflammatory drugs used in Brazil for osteoarthritis.
PATIENTS AND METHODS: Randomized clinical trials evaluating ultramicronised diclofenac, diclofenac, celecoxib, etodolac and placebo in patients with osteoarthritis were identified. A search was conducted in May 2021 through PubMed, Scopus and Web of Science databases. A network meta-analysis was developed for efficacy outcome related to analgesia measured by the pain subscale of the Western Ontario and McMaster Universities tool. In addition, surface under the cumulative ranking was performed to rank the drugs in relation to this outcome.
RESULTS: Twelve randomized clinical trials were included. Overall, ultramicronised diclofenac 105 mg/day (UD105) was better than all the others, including ultramicronised diclofenac 70 mg/day (UD70). In addition, surface under the cumulative ranking resulted in the following order: 1) ultramicronised diclofenac 105 mg/day (100%), 2) ultramicronised diclofenac 70 mg/day (80%), 3) celecoxib 200 mg/day (49%), 4) diclofenac 100 mg/day (48%), 5) placebo (19%) and 6) diclofenac 150 mg/day (6%).
CONCLUSIONS: Ultramicronised diclofenac demonstrated superior efficacy compared to other conventional anti-inflammatory drugs and placebo in relieving osteoarthritis pain.
OBJECTIVE: Current global guidelines regarding the first-line analgesics (acetaminophen, topical or oral non-steroidal anti-inflammatory drugs [NSAIDs]) for knee osteoarthritis remain controversial and their comparative risk-benefit profiles have yet to be adequately assessed.
DESIGN: Pubmed, Embase, Cochrane Library, and Web of Science were searched from database inception to March 2021 for randomized controlled trials (RCTs) comparing acetaminophen, topical NSAIDs and oral NSAIDs directly or indirectly in knee osteoarthritis. Bayesian network meta-analyses were conducted. A propensity-score matched cohort study was also conducted among patients with knee osteoarthritis in The Health Improvement Network database.
RESULTS: 122 RCTs (47,113 participants) were networked. Topical NSAIDs were superior to acetaminophen (standardized mean difference [SMD]=-0.29, 95% credible interval [CrI]: -0.52 to -0.06) and not statistically different from oral NSAIDs (SMD=0.03, 95% CrI: -0.16 to 0.22) for function. It had lower risk of gastrointestinal adverse effects (AEs) than acetaminophen (relative risk [RR]=0.52, 95%CrI: 0.35 to 0.76) and oral NSAIDs (RR=0.46, 95%CrI: 0.34 to 0.61) in RCTs. In real-world data, topical NSAIDs showed lower risks of all-cause mortality (hazard ratio [HR]=0.59, 95% confidence interval [CI]: 0.52 to 0.68), cardiovascular diseases (HR=0.73, 95%CI: 0.63 to 0.85) and gastrointestinal bleeding (HR=0.53, 95%CI: 0.41 to 0.69) than acetaminophen during the one-year follow-up (n=22,158 participants/group). A better safety profile was also observed for topical than oral NSAIDs (n=14,218 participants/group).
CONCLUSIONS: Topical NSAIDs are more effective than acetaminophen but not oral NSAIDs for function improvement in people with knee osteoarthritis. Topical NSAIDs are safer than acetaminophen or oral NSAIDs in trials and real-world data.
OBJECTIVE: Despite an extensive body of research on NSAIDs in osteoarthritis, the duration of their efficacy and timeline of adverse event (AE) onset have been understudied. We conducted a systematic review and meta-analyses from 2 to 26 weeks to characterize the efficacy and AE trajectories of oral NSAIDs in knee osteoarthritis.
METHODS: We searched MEDLINE, EMBASE, Web of Science, Google Scholar, and the Cochrane Database from inception to May 2018. RCTs assessing the efficacy and/or safety of FDA-approved NSAIDs in knee osteoarthritis patients were included. Two independent reviewers assessed quality and extracted data. We calculated standardized mean differences and risk ratios with 95% confidence intervals.
RESULTS: We included 72 RCTs (26,424 participants). NSAIDs demonstrated moderate, statistically significant effects on pain that peaked at 2 weeks (SMD -0.43 [-0.48, -0.38]), but the magnitude of the effects decreased over time. The results for function were similar. The incidence of GI AEs was significantly higher in NSAID users than placebo users as early as 4 weeks (RR 1.38 [1.21, 1.57]). The incidence of CV AEs in NSAID users was not significantly different from placebo. Most GI and CV AEs were transient and of minor severity.
CONCLUSION: NSAIDs produced significant pain and function improvements that peaked at 2 weeks but decreased over time. The incidence of minor GI and CV AEs consistently rose, reaching significance as early as 4 weeks. Clinicians should weigh the durability of efficacy with the early onset of minor AEs along with patient tolerability and preferences when formulating an NSAID regimen. This article is protected by copyright. All rights reserved.
OBJECTIVE: Despite an extensive body of research on nonsteroidal antiinflammatory drugs (NSAIDs) in osteoarthritis, the duration of their efficacy and timeline of adverse event (AE) onset have been understudied. We conducted a systematic review and meta-analyses from 2 to 26 weeks to characterize the efficacy and AE trajectories of oral NSAIDs in knee osteoarthritis.METHODS: We searched MEDLINE, Embase, Web of Science, Google Scholar, and the Cochrane Database from inception to May 2018. Randomized controlled trials assessing the efficacy and/or safety of Federal Drug Administration-approved NSAIDs in knee osteoarthritis patients were included. Two independent reviewers assessed quality and extracted data. We calculated standardized mean differences (SMDs) and risk ratios (RRs) with 95% confidence intervals (95% CIs).RESULTS: We included 72 randomized controlled trials (26,424 participants). NSAIDs demonstrated moderate, statistically significant effects on pain that peaked at 2 weeks (SMD -0.43 [95% CI -0.48, -0.38]), but the magnitude of the effects decreased over time. The results for function were similar. The incidence of gastrointestinal (GI) AEs was significantly higher in NSAID users than placebo users as early as 4 weeks (RR 1.38 [95% CI 1.21, 1.57]). The incidence of cardiovascular (CV) AEs in NSAID users was not significantly different from placebo. Most GI and CV AEs were transient and of minor severity.CONCLUSION: NSAIDs produced significant pain and function improvements that peaked at 2 weeks but decreased over time. The incidence of minor GI and CV AEs consistently rose, reaching significance as early as 4 weeks. Clinicians should weigh the durability of efficacy with the early onset of minor AEs along with patient tolerability and preferences when formulating an NSAID regimen.
OBJECTIVE: Our aim was to assess the safety of cyclooxygenase-2 (COX-2) inhibitors in the management of osteoarthritis (OA) in a systematic review and meta-analysis of randomized, placebo-controlled trials.
METHODS: A comprehensive literature search was undertaken in the databases MEDLINE, Cochrane Central Register of Controlled Trials (Ovid CENTRAL) and Scopus. Randomized, double-blind, placebo-controlled, parallel-group trials that assessed adverse events (AEs) with COX-2 inhibitors in patients with OA were eligible for inclusion. Two authors appraised titles, abstracts and full-text papers for suitability and then assessed the studies for random sequence generation, allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete outcome data and selective outcomes reporting. The primary outcomes of interest were gastrointestinal disorders, cardiac disorders, vascular disorders, nervous system disorders, skin and subcutaneous tissue disorders, hepatobiliary disorders, renal and urinary disorders, as well as overall severe and serious AEs, drug-related AEs and mortality. Secondary outcomes were withdrawals due to AEs (i.e. the number of participants who stopped the treatment due to an AE) and total number of AEs (i.e. the number of patients who experienced any AE at least once).
RESULTS: Database searches identified 2149 records from which, after exclusions, 40 trials were included in the meta-analysis. The use of COX-2 inhibitors in OA was associated with a significant increased risk of drug-related AEs compared with placebo (relative risk (RR) 1.26, 95% CI 1.09-1.46; I2 = 24%). The risk of upper gastrointestinal complications (including dyspepsia, gastritis and heartburn) was significantly increased with COX-2 inhibitors versus placebo (RR 1.19, 95% CI 1.03-1.38; I2 = 0%), particularly for abdominal pain, which increased by 40% with COX-2 inhibitors (RR 1.40, 95% CI 1.08-1.80; I2 = 0%). The risk of hypertension increased by 45% overall (RR 1.45, 95% CI 1.01-2.10; I2 = 25%); however, when rofecoxib was removed from the analysis the risk of hypertension in the COX-2 inhibitor group was no longer significant (RR 1.21, 95% CI 0.80-1.83; I2 = 20%). The overall risk of heart failure and edema was increased by nearly 70% with COX-2 inhibitors versus placebo (RR 1.68, 95% CI 1.22-2.31; 0%) and this level of risk did not change appreciably when rofecoxib was excluded (RR 1.67, 95% CI 1.21-2.29; 0%).
CONCLUSIONS: In our analysis, COX-2 inhibitors were associated with an increased risk of upper gastrointestinal AEs, especially abdominal pain. We also found an increased risk of cardiovascular AEs with COX-2 inhibitors, namely hypertension, heart failure and edema.
INTRODUCTION: Knee osteoarthritis (KOA) is a significant health problem with lifetime risk of development estimated to be 45%. Effective nonsurgical treatments are needed for the management of symptoms.
METHODS: We designed a network meta-analysis to determine clinically relevant effectiveness of nonsteroidal anti-inflammatory drugs, acetaminophen, intra-articular (IA) corticosteroids, IA platelet-rich plasma, and IA hyaluronic acid compared with each other as well as with oral and IA placebos. We used PubMed, EMBASE, and Cochrane Central Register of Controlled Trials to perform a systematic search of KOA treatments with no date limits and last search on October 7, 2015. Article inclusion criteria considered the following: target population, randomized controlled study design, English language, human subjects, treatments and outcomes of interest, ≥30 patients per group, and consistent follow-up. Using the best available evidence, two abstractors independently extracted pain and function data at or near the most common follow-up time.
RESULTS: For pain, all active treatments showed significance over oral placebo, with IA corticosteroids having the largest magnitude of effect and significant difference only over IA placebo. For function, no IA treatments showed significance compared with either placebo, and naproxen was the only treatment showing clinical significance compared with oral placebo. Cumulative probabilities showed naproxen to be the most effective individual treatment, and when combined with IA corticosteroids, it is the most probable to improve pain and function.
DISCUSSION: Naproxen ranked most effective among conservative treatments of KOA and should be considered when treating pain and function because of its relative safety and low cost. The best available evidence was analyzed, but there were instances of inconsistency in the design and duration among articles, potentially affecting uniform data inclusion.
OBJECTIVES: To compare the efficacies of oral glucosamine, chondroitin, the combination of glucosamine and chondroitin, acetaminophen and celecoxib on the treatment of knee and/or hip osteoarthritis.
METHODS: We searched electronic databases including PubMed, Embase, and Cochrane Library and the reference lists of relevant articles published from inception to October 23, 2017. A Bayesian hierarchical random effects model was used to examine the overall effect size among mixed multiple interventions.
RESULTS: We identified 61 randomised controlled trials of patients with knee and/or hip osteoarthritis. There was no obvious difference in the results between the traditional meta-analysis and the network meta-analysis. The network meta-analysis demonstrated that celecoxib was most likely the best option (SMD, -0.32 [95% CI, -0.38 to -0.25]) for pain, followed by the combination of glucosamine and chondroitin. For physical function, all interventions were significantly superior to oral placebo except for acetaminophen. In terms of stiffness, glucosamine (SMD, -0.36 [95% CI, -0.67 to -0.06]) and celecoxib (SMD, -0.29 [95% CI, -0.51 to -0.08]) were significantly better compared to placebo. In view of safety, compared to placebo only, celecoxib and acetaminophen presented significant differences.
CONCLUSIONS: Given the effectiveness of these non-steroidal anti-inflammatory drugs and symptomatic slow-acting drugs, oral celecoxib is more effective than placebo on relieving pain and improving physical function, followed by the combination of glucosamine and chondroitin. Acetaminophen is likely the least efficacious intervention option. This information, accompanied by the tolerability and economic costs of the included treatments, would be conducive to making decisions for clinicians.
Antecedentes: Los fármacos antiinflamatorios no esteroideos (AINE) son la columna vertebral del tratamiento del dolor de la osteoartritis. Para este metanálisis de la red, se consideraron los ensayos aleatorios que compararon cualquiera de las siguientes intervenciones: AINEs, paracetamol o placebo, con el fin de evaluar la eficacia de diferentes preparaciones y dosis de AINEs en el dolor de osteoartritis en un metaanálisis de red. Para el tratamiento del dolor de la osteoartritis. Se realizaron búsquedas en el Registro Cochrane Central de Ensayos Controlados (CENTRAL) y en las listas de referencias de artículos relevantes para ensayos publicados entre el 1 de enero de 1980 y el 24 de febrero de 2015, con al menos 100 pacientes por grupo. Los resultados preespecificados primarios y secundarios fueron dolor y función física, y se extrajeron por duplicado hasta siete puntos de tiempo después del inicio del tratamiento. Utilizamos una extensión de modelos de efectos aleatorios bayesianos multivariables para comparaciones mixtas de tratamiento múltiple con un efecto aleatorio a nivel de ensayos. Para el análisis primario, una caminata aleatoria de primer orden se utilizó para dar cuenta de múltiples resultados de seguimiento de resultados dentro de un ensayo. Los preparados que utilizaron diferentes dosis diarias totales se consideraron por separado en el análisis. Para evaluar una posible relación dosis-respuesta, se utilizaron covariables específicos de la preparación asumiendo la linealidad en la dosis relativa log. RECOLECCIONES: Se identificaron 8973 manuscritos de nuestra búsqueda, de los cuales 76 ensayos aleatorios con un total de 58 451 pacientes fueron incluidos en este análisis. Se consideraron 23 ganglios en relación con siete AINE diferentes o paracetamol con dosis diaria específica de administración o placebo. Todas las preparaciones, independientemente de la dosis, mejoraron las estimaciones puntuales de los síntomas del dolor en comparación con el placebo. Para seis intervenciones (diclofenaco 150 mg / día, etoricoxib 30 mg / día, 60 mg / día y 90 mg / día y rofecoxib 25 mg / día y 50 mg / día), la probabilidad de que la diferencia con el placebo sea de Por debajo de un mínimo preespecificado efecto clínicamente importante para la reducción del dolor (tamaño del efecto [ES] -0 · 37) fue de al menos el 95%. Entre las dosis diarias máximas aprobadas, diclofenaco 150 mg / día (ES -0,57, 95% de intervalo de credibilidad [CrI] -0,69 a -0,45) y 60 mg de etoricoxib / día (ES -0,58, -0 · 74 a -0 · 43) tuvieron la mayor probabilidad de ser la mejor intervención, ambos con un 100% de probabilidad de alcanzar la mínima diferencia clínicamente importante. Los efectos del tratamiento aumentaron a medida que aumentó la dosis de fármaco, pero las pruebas correspondientes para un efecto de dosis lineal fueron significativas sólo para el naproxeno (p = 0, 034). No se encontró evidencia de que los efectos del tratamiento variaran durante la duración del tratamiento. El ajuste del modelo fue bueno, y la heterogeneidad entre los ensayos y la inconsistencia fueron bajas en todos los análisis. Se consideró que todos los ensayos tenían un bajo riesgo de sesgo para el cegamiento de los pacientes. Las estimaciones de los efectos no cambiaron en los análisis de sensibilidad con dos modelos estadísticos adicionales y en la contabilidad de los criterios de calidad metodológica en el análisis de metarregresión.INTERPRETACIÓN: Sobre la base de los datos disponibles, no se observa papel del paracetamol monoterapia para el tratamiento de pacientes con Osteoartritis independientemente de la dosis. Proporcionamos pruebas sólidas de que el diclofenaco 150 mg / día es el AINE más efectivo disponible en la actualidad, en términos de mejorar tanto el dolor como la función. Sin embargo, teniendo en cuenta el perfil de seguridad de estos fármacos, los médicos deben considerar nuestros resultados junto con toda la información de seguridad conocida al seleccionar la preparación y la dosis para pacientes individuales.Fundación: Swiss National Science Foundation (subvención número 405340-104762) y Arco Foundation , Suiza.
La osteoartritis (OA) es la forma más común de artritis y es causada por la degeneración del cartílago articular y el crecimiento de hueso nuevo, cartílago y tejido conectivo. A menudo se asocia con discapacidad mayor y deterioro de la calidad de vida. Actualmente no hay consenso sobre el mejor tratamiento para mejorar los síntomas de OA. Celecoxib es un fármaco antiinflamatorio no esteroideo selectivo (AINE). OBJETIVOS: Evaluar los beneficios clínicos de celecoxib en la osteoartritis (OA, por sus siglas en inglés) (dolor, función, calidad de vida) y seguridad (retiros debidos a efectos adversos, efectos adversos graves, tasas generales de interrupción). Métodos de búsqueda: Se realizaron búsquedas en los registros del Registro Central de Ensayos Controlados (CENTRAL), MEDLINE, Embase y ensayos clínicos de Cochrane hasta el 11 de abril de 2017, así como listas de referencias y citas de los estudios incluidos. Se estableció contacto con las empresas farmacéuticas y los autores de los artículos publicados. Se incluyeron estudios publicados (informes completos en una revista revisada por pares) de ensayos controlados aleatorios prospectivos (ECA) que compararon celecoxib oral versus ninguna intervención, placebo u otro AINE tradicional (tNSAID) en participantes con cefaleas clínicamente confirmadas o radiológicamente confirmadas OA de la rodilla o de la cadera o de la rodilla y de la cadera. Dos autores realizaron de forma independiente la extracción de datos, la evaluación de la calidad y los resultados comparados. Los principales análisis de los resultados informados por el paciente de dolor y función física se realizaron en estudios con bajo riesgo de sesgo para la generación de secuencias, el ocultamiento de la asignación y el cegamiento de los participantes y el personal. Se incluyeron 36 ensayos que proporcionaron datos para 17.206 adultos: 9402 participantes recibieron celecoxib 200 mg / día, y 7804 fueron asignados para recibir tNSAIDs (N = 1869) o placebo (N = 5935). Celecoxib se comparó con placebo (32 ensayos), naproxeno (6 ensayos) y diclofenaco (3 ensayos). Los estudios se publicaron entre 1999 y 2014. Los estudios incluyeron participantes con OA de rodilla, cadera o de rodilla y cadera; La duración media de OA fue de 7,9 años. La mayoría de los estudios incluyeron participantes predominantemente blancos cuya edad media fue 62 (± 10) años; La mayoría de los participantes eran mujeres. No hubo preocupaciones sobre el riesgo de sesgo por el desempeño y sesgo de detección, pero el sesgo de selección fue mal informado en la mayoría de los ensayos. La mayoría de los ensayos presentaron un sesgo de desgaste elevado, y hubo evidencia de notificación selectiva en un tercio de los estudios. Celecoxib versus placebo En comparación con el placebo, celecoxib redujo levemente el dolor en una escala de dolor de 500 puntos de Western Ontario y McMaster Universities Arthritis Index (WOMAC), lo que representa una mejoría absoluta del 3% (IC del 95% 2% a 5% IC del 95% mejoría del 7% al 18%) (4 estudios, 1622 participantes). En comparación con el placebo, el celecoxib mejora ligeramente la función física en una escala WOMAC de 1700 puntos, lo que representa un 4% de mejoría absoluta (IC del 95%, 2% a 6% de mejoría), un 12% relativo (IC del 95%: 5% a 19% de mejoría) (4 estudios, 1622 participantes). Esta mejoría puede no ser clínicamente significativa (evidencia de alta calidad). No hubo evidencia de una diferencia importante para los retiros debido a eventos adversos (Peto OR 0,99, IC del 95%: 0,85 a 1,15) (evidencia de calidad moderada debido a las limitaciones del estudio). (Peto OR 0,95, IC del 95%: 0,66 a 1,36), eventos gastrointestinales (Peto OR 1,91, IC del 95%: 0,24 a 14,90) y eventos cardiovasculares (Peto OR 3,40, IC del 95%: 0,73 a 15,88) (evidencia de muy baja calidad debido a imprecisiones graves y limitaciones del estudio). Sin embargo, las agencias reguladoras han advertido sobre el aumento de los eventos cardiovasculares para el celecoxib. Celecoxib vs tNSAIDs Hubo resultados no concluyentes sobre el efecto sobre el dolor entre celecoxib y tNSAIDs en una escala analógica visual (EVA) de 100 puntos, mostrando una mejora absoluta del 5% (IC del 95%: 11% mejora a 2% peor) (2 estudios, 1180 participantes, evidencia de calidad moderada debido al sesgo de publicación). Comparado con un tNSAID, el celecoxib mejoró ligeramente la función física en una escala WOMAC de 100 puntos, mostrando un 6% de mejoría absoluta ( IC del 95% mejoría de 6% a 11%) y mejora relativa del 16% (IC del 95% mejoría de 2% a 30%). (1 estudio, 264 participantes). Basado en evidencia de baja o muy baja calidad (degradado debido a la ausencia de datos, alto riesgo de sesgo, pocos eventos y (Peto OR 0,97, IC del 95%: 0,74 a 1,27), número de participantes con SAE (Peto OR 0,92, IC del 95%: 0,66 a 1,28), eventos gastrointestinales (Peto OR 0,61, 0,15 a 2,43) y eventos cardiovasculares (Peto OR 0.47, IC del 95%: 0,17 a 1,25). En las comparaciones de celecoxib y placebo no hubo diferencias en los análisis agrupados entre nuestro análisis principal con bajo riesgo de sesgo y todos los estudios elegibles. En las comparaciones de celecoxib y tNSAIDs, sólo un resultado mostró una diferencia entre los estudios con bajo riesgo de sesgo y todos los estudios elegibles: función física (6% de mejora absoluta en el bajo riesgo de sesgo, ninguna diferencia en todos los estudios elegibles). Las principales comparaciones midieron la calidad de vida. De los 36 estudios, 34 informaron de la financiación de los fabricantes de fármacos y en 34 estudios uno o más autores del estudio fueron empleados del patrocinador. CONCLUSIONES DE LOS AUTORES: Estamos muy reservados sobre los resultados debido a la participación de la industria farmacéutica y datos limitados. No se pudieron obtener los datos de tres estudios, que incluyeron 15.539 participantes, y se clasificaron como aguardando evaluación. La evidencia actual indica que el celecoxib es ligeramente mejor que el placebo y algunos AINEs para reducir el dolor y mejorar la función física. No estamos seguros si los daños difieren entre celecoxib y placebo o tNSAIDs debido al riesgo de sesgo, evidencia de baja calidad para muchos resultados y que algunos autores del estudio y Pfizer declinaron proporcionar datos de estudios completados con un gran número de participantes. Para llenar la brecha de evidencia, necesitamos acceder a los datos existentes y nuevos ensayos clínicos independientes para investigar los beneficios y los daños del celecoxib versus tNSAIDs para las personas con osteoartritis, con un seguimiento más prolongado y comparaciones directas directa con otros tNSAID.
The efficacy of cyclooxygenase-2 (COX-2) inhibitors, including celecoxib, in managing knee osteoarthritis (KO) is well-established. Recently, the plant extract cocktail JOINS (SKI306X and its newer formulation, SKCPT) has been shown to be an effective slow-acting drug for KO. Aims: To compare the efficacy and safety of celecoxib and JOINS in patients with KO.
METHODS:
A systematic search of the MEDLINE, Embase, and Cochrane Library databases identified randomized controlled trials (RCTs) assessing the effectiveness and safety of celecoxib and JOINS. The outcomes included pain relief, functional improvement, and safety profiles. Outcome measurements were compared between the celecoxib and JOINS cohorts at the short-term (closest to 3 months) and mid-term (closest to 12 months).
RESULTS:
Overall, 23 RCTs involving 3367 patients were included in this systematic review. The efficacy of JOINS in reducing pain, as indicated by the visual analog scale (VAS) score, was comparable to that of celecoxib. Regarding functional improvement assessed using the Western Ontario and McMaster University Arthritis Index (WOMAC), JOINS showed improvement comparable to that of celecoxib regardless of follow-up. In addition, no significant difference was observed in the incidence of adverse events between the celecoxib and JOINS cohorts.
CONCLUSIONS:
The results of this study suggest that JOINS could be considered as a pharmacological agent with significant efficacy for pain relief and functional improvement in patients with KO in clinical practice.
Pregunta de la revisión sistemática»Revisión sistemática de intervenciones
