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General medicine
NSAIDs are superior to paracetamol for osteoarthritic pain and function in a network meta-analysis
  1. Sten Rasmussen1,2
  1. 1 Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg, Denmark
  2. 2 Department of Clinical Medicine, Aalborg University School of Medicine and Health, Aalborg, Denmark
  1. Correspondence to Dr Sten Rasmussen, Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg 9000, Denmark; s_rasmussen{at}dcm.aau.dk

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Commentary on: da Costa BR, Reichenbach S, Keller N, et al. Effectiveness of non-steroidal anti-inflammatory drugs for the treatment of pain in knee and hip osteoarthritis: a network meta-analysis. Lancet 2017;390:e21–33.

Context

Treatment of osteoarthritis includes analgesics, exercise, lifestyle changes, weight loss and other adaptations. Analgesics are often recommended and used together with exercise therapy. Recent studies and reviews support the use of exercise therapy as the first choice of treatment for osteoarthritis, followed by non-steroidal anti-inflammatory drugs (NSAIDs) and other modalities.1–4 However, several NSAIDs are available, and the preferred NSAID and dose for osteoarthritis are different between the available studies and recommendations.

Methods

This was a network meta-analysis of randomised controlled trials (RCTs) of different doses of NSAIDs or paracetamol …

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