Nonsteroidal Antiinflammatory Drugs for Axial Spondyloarthritis: A Cochrane Review.

Objective: To determine the benefits and harms of nonsteroidal antiinflammatory drugs (NSAID) in axial spondyloarthritis (axSpA).Methods: Systematic review using Cochrane Collaboration methodology.Inclusion Criteria: randomized controlled trials (RCT) and quasi-RCT (to June 2014), investigating NSAI...

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Publicado en:Journal of Rheumatology Vol. 43; no. 3; pp. 607 - 618
Autores principales: Kroon, FΥline P. B., van der Burg, Lennart R. A., Ramiro, Sofia, LandewΥ, Robert B. M., Buchbinder, Rachelle, Falzon, Louise, van der Heijde, DΥsirΥe, Kroon, Féline P B, Landewé, Robert B M, van der Heijde, Désirée
Formato: Journal Article
Publicado: Journal of Rheumatology Publishing Co. Ltd. Mar2016
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2016
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      pub: Journal of Rheumatology Publishing Co. Ltd.
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        atl: Nonsteroidal Antiinflammatory Drugs for Axial Spondyloarthritis: A Cochrane Review.
      aug:
        au:
          Kroon, FΥline P. B.
          van der Burg, Lennart R. A.
          Ramiro, Sofia
          LandewΥ, Robert B. M.
          Buchbinder, Rachelle
          Falzon, Louise
          van der Heijde, DΥsirΥe
          Kroon, Féline P B
          Landewé, Robert B M
          van der Heijde, Désirée
        affil: Department of Rheumatology, Leiden University Medical Center
      sug:
      ab: Objective: To determine the benefits and harms of nonsteroidal antiinflammatory drugs (NSAID) in axial spondyloarthritis (axSpA).Methods: Systematic review using Cochrane Collaboration methodology.Inclusion Criteria: randomized controlled trials (RCT) and quasi-RCT (to June 2014), investigating NSAID versus any control for axSpA, and observational studies of longterm effects (≥ 6 mos) of NSAID on radiographic progression or adverse events. Main outcomes were pain, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, radiographic progression, number of withdrawals because of adverse events, and number of serious adverse events. Risk of bias was assessed.Results: Thirty-five RCT, 2 quasi-RCT, and 2 cohort studies were included. Twenty-nine RCT and 2 quasi-RCT (n = 4356) were included in pooled analyses [traditional NSAID vs placebo (n = 5), cyclooxygenase-2 (COX-2) vs placebo (n = 3), COX-2 vs traditional NSAID (n = 4), NSAID vs NSAID (n = 24), naproxen vs other NSAID (n = 3), and low- vs high-dose NSAID (n = 5)]. Compared with placebo, both traditional and COX-2 NSAID were consistently more efficacious at 6 weeks and equally safe after 12 weeks. No significant differences in benefits or harms between the 2 NSAID classes and no important differences in benefits or withdrawals because of adverse events between different NSAID were found, especially if studies with high risk of bias were excluded. Single studies suggest NSAID may retard radiographic progression, especially by continuous rather than on-demand NSAID use.Conclusion: High-quality evidence indicates that both traditional and COX-2 NSAID are efficacious for treating axSpA, and harms are not different from placebo in the short term. Various NSAID are equally effective.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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