変形性膝関節症に対するNSAIDとオピオイドの効果:系統的総説

OAに対するNSAIDsとオピオイドの効果の相対的な有効性の系統的総説。無作為振り分け対照研究。17の研究から27 の治療法(9つの celecoxib,4つの非選択的NSAIDs[diclofenac, naproxen, piroxicam], 11の弱オピオイド [tramadol], および3 つの強オピオイド[hydromorphone,oxycodone]). NSAIDおよびオピオイド研究はベースラインの人口統計的データが同程度であり効果の点での脱落の率が同程度;NSAID研究はベースラインの痛みが低く、毒性による脱落の率が低い.効果に関連した脱落, すべての薬のクラスは同程度の痛みの軽減(NSAIDs: -18; opioids:-18;opioids:-19). メタ回帰によると、薬のクラスによる効果の差は見つからなかったが、女性およびベースラインの平均の痛みが強い者の割合が多いコホート研究は痛みの低下が強い。同様に、ネットワークメタ解析では、三つの鎮痛薬のクラスでは、WOMAC Painの低下には有意差はなかった。

OsteoarthritisCartilage. 2016 Feb 1. pii: S1063-4584(16)00154-0. doi:10.1016/j.joca.2016.01.135. [Epub ahead of print]

Comparative pain reduction of oral non-steroidalanti-inflammatorydrugs and opioids for knee osteoarthritis: Systematic analytic review.

Smith SR1, DeshpandeBR2, CollinsJE3, Katz JN4, Losina E5.

  • 1Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA. Electronic address: ssmith94@partners.org.
  • 2Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA. Electronic address: bdeshpande@partners.org.
  • 3Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Brigham and Women's Hospital, Boston, MA. Electronic address: jcollins13@partners.org.
  • 4Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Brigham and Women's Hospital, Boston, MA; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA; Departments of Epidemiology and Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA. Electronic address: jnkatz@partners.org.
  • 5Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Brigham and Women's Hospital, Boston, MA; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA; Department of Biostatistics, Boston University School of Public Health, Boston, MA. Electronic address: elosina@partners.org.

[PR]

by fibromyalgia11 | 2016-02-09 20:45 | アセトアミノフェン、NSAID
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世界標準の線維筋痛症を専門家が説明します


by fibromyalgia11
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