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NSAIDs are of limited use for osteoarthritis

Non-steroidal anti-inflammatory drugs, including cyclo-oxygenase-2 inhibitors, in osteoarthritic knee pain: meta-analysis of randomised placebo controlled trials BMJ Online First

BMJ

Patients with knee osteoarthritis should avoid long term use of non-steroidal anti-inflammatory drugs (NSAIDs), say researchers in a study published on bmj.com today.

Current guidelines recommend the use of oral NSAIDs in the treatment of knee osteoarthritis and they are used regularly by half of all patients with painful osteoarthritis.

Researchers in Norway analysed 23 trials to estimate the pain relieving effects of NSAIDs in patients with knee osteoarthritis. The final sample involved 10,845 patients, of whom 7767 received NSAIDs and 3078 received placebo.

The analysis revealed that NSAIDs can reduce short term pain slightly better than placebo, but it does not support long term use of NSAIDs for this condition, say the authors. The advantage of oral NSAIDs over placebo for short term pain relief is small and probably clinically insignificant, they add.

"As use of oral NSAIDs may incur serious adverse effects, they can only be recommended for limited use in osteoarthritis of the knee," they conclude.

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