FELDENE 10 mg, gélule, flacon de 30Chronic back pain is an important health problem. Non-steroidal anti-inflammatory drugs NSAIDs are widely used to treat people with low back pain, especially people with acute back pain. Ina Cochrane review trt replacement a small but significant effect from NSAIDs anti inflammatoires steroidiens to placebo in people with chronic back pain. This is an update of the Cochrane review published in and anti inflammatoires steroidiens on people infammatoires chronic low back pain. We also screened references cited in relevant reviews.
Pharmacologie des anti-inflammatoires non-stéroïdiens et pathologies ORL - EM|consulte
Chronic back pain is an important health problem. Non-steroidal anti-inflammatory drugs NSAIDs are widely used to treat people with low back pain, especially people with acute back pain.
In , a Cochrane review identified a small but significant effect from NSAIDs compared to placebo in people with chronic back pain. This is an update of the Cochrane review published in and focuses on people with chronic low back pain. We also screened references cited in relevant reviews. Two review authors independently screened trials for inclusion in this Cochrane review according to the inclusion criteria. One review author extracted the data, and a second review author checked the data.
Two review authors independently evaluated the risk of bias of all included trials. If data were clinically homogeneous, we performed a meta-analysis and assessed the quality of evidence using the GRADE approach. We included 13 trials in this Cochrane review. Ten studies were at 'low' risk of bias.
There is low quality evidence that NSAIDs are more effective than placebo, with a mean difference in pain intensity score from baseline of Four studies measured disability using the Roland Morris Disability Questionnaire. There is low quality evidence that NSAIDs are more effective than placebo on disability, with a mean difference from baseline of All six placebo controlled studies also reported adverse events, and suggested that adverse events are not statistically significant more frequent in participants using NSAIDs compared to placebo RR 1.
Due to the relatively small sample size and relatively short follow-up in most included trials, it is likely that the proportion of patients experiencing an adverse event is underestimated. Two studies compared different types of non-selective NSAIDs, namely ibuprofen versus diclofenac and piroxicam versus indomethacin.
The trials did not find any differences between these NSAID types, but both trials had small sample sizes. One trial reported no differences in pain intensity between treatment groups that used selective or non-selective NSAIDs. One other trial compared diflunisal with paracetamol and showed no difference in improvement from baseline on pain intensity score. One trial showed a better global improvement in favour of celecoxib versus tramadol. Disability improved more in participants who did exercises versus participants receiving NSAIDs, but pain scores were similar.
NSAIDs are slightly more effective than placebo regarding disability. However, the magnitude of the effects is small, and the level of evidence was low.
Due to inclusion of RCTs only, the relatively small sample sizes and relatively short follow-up in most included trials, we cannot make firm statements about the occurrence of adverse events or whether NSAIDs are safe for long-term use. Interestingly, although not a rare disease and the drugs are not new , there are not many large RCTs and very few head-to-head RCTs on this topic.
This is a useful update but nowadays the choice of drug is also dictated by adverse effects and cost. We just need your email, then we'll add you to the list! Toggle navigation McMaster University info mcmasteroptimalaging. Cochrane Database Syst Rev. Voulez-vous savoir ce que lisent les professionnels?