Guangxi Colleges and Universities Key Laboratory of pharmacology, Guilin Medical University, Guilin, Guangxi, China.
Medicine (Baltimore). 2022 Sep 9;101(36):e30354. doi: 10.1097/MD.0000000000030354.
Osteoarthritis (OA) often affects the hands, knees, and hip joints, causing considerable pain and disability, and often affecting the patient's quality of life. Non-steroidal anti-inflammatory drugs (NSAIDs) are common pain relievers often applied as first line therapies for OA. However, prolonged NSAIDs application can have unwanted side effects. Given this, this study was designed to systematically evaluate the efficacy and safety of topical and oral NSAIDs for the treatment of OA.
We searched the PubMed, Embase, Cochrane Library, and Web of Science databases for relevant papers from their inception dates to May 2021. Our study only included randomized controlled trials comparing topical and oral NSAIDs and all data were analyzed using Review Manager version 5.3 (RevMan version 5.3).
We identified 8 RCTs (2096 patients with OA), for evaluation and revealed that, in general, topical and oral NSAIDs presented with similar efficacies for the treatment of OA. The Western Ontario and McMaster Osteoarthritis Index for assessing pain relief in OA patients was (standardized mean difference [SMD] 0.07; 95%CI -0.02, 0.17) and visual analog scale was (SMD -0.01; 95%CI -0.02, 0.18), and improved stiffness in OA patients (SMD 0.09; 95%Cl 0.03, 0.20).
Topical NSAIDs are as effective as oral NSAIDs for the treatment of OA and both topical and oral NSAIDs are equally effective in reducing pain and improving physical function in OA patients. In terms of safety, a larger number of samples are still needed to determine if there are any differences in the safety profile of topical or oral NSAIDs.
INPLASY 2021110009.
骨关节炎（OA）常累及手部、膝部和髋关节，引起严重疼痛和功能障碍，常影响患者的生活质量。非甾体抗炎药（NSAIDs）是常用的止痛药，常用于 OA 的一线治疗。然而，长期应用 NSAIDs 会产生不良的副作用。鉴于此，本研究旨在系统评估局部和口服 NSAIDs 治疗 OA 的疗效和安全性。
我们检索了 PubMed、Embase、Cochrane 图书馆和 Web of Science 数据库，从建库日期至 2021 年 5 月，收集了关于局部和口服 NSAIDs 治疗 OA 的相关文献。本研究仅纳入比较局部和口服 NSAIDs 的随机对照试验，所有数据均采用 Review Manager 5.3 版（RevMan 版本 5.3）进行分析。
我们共纳入 8 项 RCT（2096 例 OA 患者）进行评估，结果表明，局部和口服 NSAIDs 治疗 OA 的总体疗效相当。评估 OA 患者疼痛缓解的 Western Ontario and McMaster Osteoarthritis Index 为（标准化均数差 [SMD] 0.07；95%CI -0.02, 0.17），视觉模拟评分法为（SMD -0.01；95%CI -0.02, 0.18），OA 患者的僵硬程度也有所改善（SMD 0.09；95%Cl 0.03, 0.20）。
局部 NSAIDs 与口服 NSAIDs 治疗 OA 的疗效相当，且局部和口服 NSAIDs 在减轻 OA 患者疼痛和改善躯体功能方面同样有效。关于安全性，还需要更多的样本量来确定局部或口服 NSAIDs 的安全性谱是否存在差异。
INPLASY 2021110009。
