Tags

Type your tag names separated by a space and hit enter

Safety and efficacy of on-demand versus continuous use of nonsteroidal antiinflammatory drugs in patients with inflammatory arthritis: a systematic literature review.
J Rheumatol Suppl 2012; 90:56-8JR

Abstract

OBJECTIVE

To systematically review the efficacy and safety of on-demand versus continuous use of nonsteroidal antiinflammatory drugs (NSAID) in patients with inflammatory arthritis and to assess if longterm continuous treatment with NSAID in comparison with NSAID treatment on-demand reduces radiographic progression.

METHODS

A systematic literature review was performed in Medline, Embase, the Cochrane Library, and American College of Rheumatology/European League Against Rheumatism 2008-2009 meeting abstracts as part of the multinational 3e (Evidence, Expertise, Exchange) Initiative for generating practical recommendations about Pain Management by Pharmacotherapy in Inflammatory Arthritis. Articles fulfilling predefined inclusion criteria were reviewed and quality appraisal was performed.

RESULTS

The search yielded a total of 1410 articles from Medline and Embase, 73 from Cochrane Central, and 3 meeting abstracts. After review, only one study fulfilled the defined inclusion criteria, which indicated that longterm continuous treatment with NSAID versus NSAID treatment on-demand reduced radiographic progression in patients with ankylosing spondylitis. Secondary measured endpoints were disease activity measures including pain and the frequency of observed adverse events in both groups. Relevant adverse events tended to occur more frequently in the continuous treatment group with odds ratios of 2.79 for hypertension, 1.67 for abdominal pain, 1.35 for diarrhea, 0.95 for dyspepsia, and 3.2 for depression. None of these differences were statistically significant, with the exception of depression, which could not be explained.

CONCLUSION

Based on a single study, there does not seem to be a statistical difference in efficacy between the on-demand versus continuous use of NSAID in the context of ankylosing spondylitis. There were no studies in patients with rheumatoid arthritis, psoriatic arthritis, or spondyloarthritis. Research is needed to study the risk-benefit ratio of continuous versus on-demand use of NSAID.

Authors+Show Affiliations

Department of Internal Medicine, Rheumatology Service, Centre Hospitalier Universitaire de l'Université Laval, Québec, Quebec, Canada. karen.adams@utoronto.caNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

22942330

Citation

Adams, Karen, et al. "Safety and Efficacy of On-demand Versus Continuous Use of Nonsteroidal Antiinflammatory Drugs in Patients With Inflammatory Arthritis: a Systematic Literature Review." The Journal of Rheumatology. Supplement, vol. 90, 2012, pp. 56-8.
Adams K, Bombardier C, van der Heijde D. Safety and efficacy of on-demand versus continuous use of nonsteroidal antiinflammatory drugs in patients with inflammatory arthritis: a systematic literature review. J Rheumatol Suppl. 2012;90:56-8.
Adams, K., Bombardier, C., & van der Heijde, D. (2012). Safety and efficacy of on-demand versus continuous use of nonsteroidal antiinflammatory drugs in patients with inflammatory arthritis: a systematic literature review. The Journal of Rheumatology. Supplement, 90, pp. 56-8. doi:10.3899/jrheum.120343.
Adams K, Bombardier C, van der Heijde D. Safety and Efficacy of On-demand Versus Continuous Use of Nonsteroidal Antiinflammatory Drugs in Patients With Inflammatory Arthritis: a Systematic Literature Review. J Rheumatol Suppl. 2012;90:56-8. PubMed PMID: 22942330.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Safety and efficacy of on-demand versus continuous use of nonsteroidal antiinflammatory drugs in patients with inflammatory arthritis: a systematic literature review. AU - Adams,Karen, AU - Bombardier,Claire, AU - van der Heijde,Désirée, PY - 2012/9/4/entrez PY - 2012/9/4/pubmed PY - 2013/1/18/medline SP - 56 EP - 8 JF - The Journal of rheumatology. Supplement JO - J Rheumatol Suppl VL - 90 N2 - OBJECTIVE: To systematically review the efficacy and safety of on-demand versus continuous use of nonsteroidal antiinflammatory drugs (NSAID) in patients with inflammatory arthritis and to assess if longterm continuous treatment with NSAID in comparison with NSAID treatment on-demand reduces radiographic progression. METHODS: A systematic literature review was performed in Medline, Embase, the Cochrane Library, and American College of Rheumatology/European League Against Rheumatism 2008-2009 meeting abstracts as part of the multinational 3e (Evidence, Expertise, Exchange) Initiative for generating practical recommendations about Pain Management by Pharmacotherapy in Inflammatory Arthritis. Articles fulfilling predefined inclusion criteria were reviewed and quality appraisal was performed. RESULTS: The search yielded a total of 1410 articles from Medline and Embase, 73 from Cochrane Central, and 3 meeting abstracts. After review, only one study fulfilled the defined inclusion criteria, which indicated that longterm continuous treatment with NSAID versus NSAID treatment on-demand reduced radiographic progression in patients with ankylosing spondylitis. Secondary measured endpoints were disease activity measures including pain and the frequency of observed adverse events in both groups. Relevant adverse events tended to occur more frequently in the continuous treatment group with odds ratios of 2.79 for hypertension, 1.67 for abdominal pain, 1.35 for diarrhea, 0.95 for dyspepsia, and 3.2 for depression. None of these differences were statistically significant, with the exception of depression, which could not be explained. CONCLUSION: Based on a single study, there does not seem to be a statistical difference in efficacy between the on-demand versus continuous use of NSAID in the context of ankylosing spondylitis. There were no studies in patients with rheumatoid arthritis, psoriatic arthritis, or spondyloarthritis. Research is needed to study the risk-benefit ratio of continuous versus on-demand use of NSAID. SN - 0380-0903 UR - https://www.unboundmedicine.com/medline/citation/22942330/Safety_and_efficacy_of_on_demand_versus_continuous_use_of_nonsteroidal_antiinflammatory_drugs_in_patients_with_inflammatory_arthritis:_a_systematic_literature_review_ L2 - http://www.jrheum.org/cgi/pmidlookup?view=long&pmid=22942330 DB - PRIME DP - Unbound Medicine ER -