Scolaris Content Display Scolaris Content Display

Comparison 1 NSAIDS versus PLACEBO, Outcome 1 PAIN RELIEF ‐ SUBJECTIVE.
Figures and Tables -
Analysis 1.1

Comparison 1 NSAIDS versus PLACEBO, Outcome 1 PAIN RELIEF ‐ SUBJECTIVE.

Study

Comparison

Outcome

No of participants

NSAID

Placebo

Significance

Osathanondh 1985

Fenoprofen 200mg vs placebo

Mean (SD) pain intensity score post treatment

18 on fenoprofen, 24 on placebo

0.79 (0.90)

1.44 (1.04)

p <0.01

Figures and Tables -
Analysis 1.2

Comparison 1 NSAIDS versus PLACEBO, Outcome 2 PAIN INTENSITY: PARALLEL DESCRIPTIVE DATA.

Comparison 1 NSAIDS versus PLACEBO, Outcome 3 ADVERSE EFFECTS ‐ GASTROINTESTINAL.
Figures and Tables -
Analysis 1.3

Comparison 1 NSAIDS versus PLACEBO, Outcome 3 ADVERSE EFFECTS ‐ GASTROINTESTINAL.

Comparison 1 NSAIDS versus PLACEBO, Outcome 4 ADVERSE EFFECTS ‐ NERVOUS SYSTEM.
Figures and Tables -
Analysis 1.4

Comparison 1 NSAIDS versus PLACEBO, Outcome 4 ADVERSE EFFECTS ‐ NERVOUS SYSTEM.

Comparison 1 NSAIDS versus PLACEBO, Outcome 5 ADVERSE EFFECTS ‐ ALL.
Figures and Tables -
Analysis 1.5

Comparison 1 NSAIDS versus PLACEBO, Outcome 5 ADVERSE EFFECTS ‐ ALL.

Comparison 1 NSAIDS versus PLACEBO, Outcome 6 ADDITIONAL ANALGESICS REQUIRED.
Figures and Tables -
Analysis 1.6

Comparison 1 NSAIDS versus PLACEBO, Outcome 6 ADDITIONAL ANALGESICS REQUIRED.

Comparison 1 NSAIDS versus PLACEBO, Outcome 7 INTERFERENCE WITH DAILY ACTIVITIES.
Figures and Tables -
Analysis 1.7

Comparison 1 NSAIDS versus PLACEBO, Outcome 7 INTERFERENCE WITH DAILY ACTIVITIES.

Comparison 1 NSAIDS versus PLACEBO, Outcome 8 ABSENCE FROM WORK/SCHOOL.
Figures and Tables -
Analysis 1.8

Comparison 1 NSAIDS versus PLACEBO, Outcome 8 ABSENCE FROM WORK/SCHOOL.

Study

Comparison

Outcome

No of participants

Aspirin

Other NSAID

Significance

Osathanondh 1985

Aspirin vs Fenoprofen

Mean (SD) pain intensity score post treatment

96 (85 analysed)

1.44 (0.99)

0.79 (0.90)

p = <0.01

Figures and Tables -
Analysis 2.1

Comparison 2 ASPIRIN versus NSAIDS, Outcome 1 PAIN INTENSITY: PARALLEL DESCRIPTIVE DATA.

Comparison 2 ASPIRIN versus NSAIDS, Outcome 2 SIDE EFFECTS ‐ GASTROINTESTINAL.
Figures and Tables -
Analysis 2.2

Comparison 2 ASPIRIN versus NSAIDS, Outcome 2 SIDE EFFECTS ‐ GASTROINTESTINAL.

Comparison 2 ASPIRIN versus NSAIDS, Outcome 3 SIDE EFFECTS ‐ NERVOUS SYSTEM.
Figures and Tables -
Analysis 2.3

Comparison 2 ASPIRIN versus NSAIDS, Outcome 3 SIDE EFFECTS ‐ NERVOUS SYSTEM.

Comparison 2 ASPIRIN versus NSAIDS, Outcome 4 SIDE EFFECTS ‐ ALL.
Figures and Tables -
Analysis 2.4

Comparison 2 ASPIRIN versus NSAIDS, Outcome 4 SIDE EFFECTS ‐ ALL.

Comparison 2 ASPIRIN versus NSAIDS, Outcome 5 ADDITIONAL ANALGESICS REQUIRED.
Figures and Tables -
Analysis 2.5

Comparison 2 ASPIRIN versus NSAIDS, Outcome 5 ADDITIONAL ANALGESICS REQUIRED.

Comparison 2 ASPIRIN versus NSAIDS, Outcome 6 INTERFERENCE WITH DAILY ACTIVITIES.
Figures and Tables -
Analysis 2.6

Comparison 2 ASPIRIN versus NSAIDS, Outcome 6 INTERFERENCE WITH DAILY ACTIVITIES.

Comparison 3 DICLOFENAC Versus NSAIDS, Outcome 1 RELIEF OF PAIN ‐ SUBJECTIVE.
Figures and Tables -
Analysis 3.1

Comparison 3 DICLOFENAC Versus NSAIDS, Outcome 1 RELIEF OF PAIN ‐ SUBJECTIVE.

Study

No of participants

Diclofenac

Other NSAID

Significance

Notes

Diclofenac vs Nimesulide

Facchinetti 2001

308

16/155

7/149

Not reported

Figures and Tables -
Analysis 3.2

Comparison 3 DICLOFENAC Versus NSAIDS, Outcome 2 ADVERSE EFFECTS ‐ GASTROINTESTINAL.

Study

Comparison

Outcome

No of participants

Fenoprofen

Other NSAID

Significance

Osathanondh 1985

Fenoprofen 200mg vs Aspirin

Men (SD) pain intensity score post treatment

Fenoprofen:18 Aspirin: 24

0.79 (0.90)

1.44 (0.99)

p = <0.01

Figures and Tables -
Analysis 4.1

Comparison 4 FENOPROFEN versus NSAIDS, Outcome 1 PAIN INTENSITY: PARALLEL DESCRIPTIVE DATA.

Comparison 4 FENOPROFEN versus NSAIDS, Outcome 2 SIDE EFFECTS ‐ ALL.
Figures and Tables -
Analysis 4.2

Comparison 4 FENOPROFEN versus NSAIDS, Outcome 2 SIDE EFFECTS ‐ ALL.

Comparison 5 IBUPROFEN versus NSAIDS, Outcome 1 PAIN RELIEF ‐ SUBJECTIVE.
Figures and Tables -
Analysis 5.1

Comparison 5 IBUPROFEN versus NSAIDS, Outcome 1 PAIN RELIEF ‐ SUBJECTIVE.

Comparison 5 IBUPROFEN versus NSAIDS, Outcome 2 SIDE EFFECTS ‐ GASTROINTESTINAL.
Figures and Tables -
Analysis 5.2

Comparison 5 IBUPROFEN versus NSAIDS, Outcome 2 SIDE EFFECTS ‐ GASTROINTESTINAL.

Comparison 5 IBUPROFEN versus NSAIDS, Outcome 3 SIDE EFFECTS ‐ NERVOUS SYSTEM.
Figures and Tables -
Analysis 5.3

Comparison 5 IBUPROFEN versus NSAIDS, Outcome 3 SIDE EFFECTS ‐ NERVOUS SYSTEM.

Comparison 5 IBUPROFEN versus NSAIDS, Outcome 4 SIDE EFFECTS ‐ ALL.
Figures and Tables -
Analysis 5.4

Comparison 5 IBUPROFEN versus NSAIDS, Outcome 4 SIDE EFFECTS ‐ ALL.

Comparison 5 IBUPROFEN versus NSAIDS, Outcome 5 ADDITIONAL ANALGESICS REQUIRED.
Figures and Tables -
Analysis 5.5

Comparison 5 IBUPROFEN versus NSAIDS, Outcome 5 ADDITIONAL ANALGESICS REQUIRED.

Comparison 6 MEFENAMIC ACID versus NSAIDS, Outcome 1 PAIN INTENSITY ‐ VAS.
Figures and Tables -
Analysis 6.1

Comparison 6 MEFENAMIC ACID versus NSAIDS, Outcome 1 PAIN INTENSITY ‐ VAS.

Study

Outcome measure

No of participants

Mefenamic acid

Nimesulide

Significance

Mefenamic acid vs Nimesulide

Lopez Rosales 1989

Pain intensity score on 1‐10 non VAS scale, summed over 3 cycles

20 in each group

6.8 (SD 0.81)

5.27 (SD 1.16)

p<0.01

Figures and Tables -
Analysis 6.2

Comparison 6 MEFENAMIC ACID versus NSAIDS, Outcome 2 PAIN INTENSITY ‐ NON VAS SCALE.

Comparison 6 MEFENAMIC ACID versus NSAIDS, Outcome 3 INTERFERENCE WITH DAILY ACTIVITIES.
Figures and Tables -
Analysis 6.3

Comparison 6 MEFENAMIC ACID versus NSAIDS, Outcome 3 INTERFERENCE WITH DAILY ACTIVITIES.

Comparison 7 NAPROXEN versus NSAIDS, Outcome 1 PAIN RELIEF‐ SUBJECTIVE.
Figures and Tables -
Analysis 7.1

Comparison 7 NAPROXEN versus NSAIDS, Outcome 1 PAIN RELIEF‐ SUBJECTIVE.

Comparison 7 NAPROXEN versus NSAIDS, Outcome 2 SIDE EFFECTS ‐ GASTROINTESTINAL.
Figures and Tables -
Analysis 7.2

Comparison 7 NAPROXEN versus NSAIDS, Outcome 2 SIDE EFFECTS ‐ GASTROINTESTINAL.

Comparison 7 NAPROXEN versus NSAIDS, Outcome 3 SIDE EFFECTS ‐ NERVOUS SYSTEM.
Figures and Tables -
Analysis 7.3

Comparison 7 NAPROXEN versus NSAIDS, Outcome 3 SIDE EFFECTS ‐ NERVOUS SYSTEM.

Comparison 7 NAPROXEN versus NSAIDS, Outcome 4 SIDE EFFECTS ‐ ALL.
Figures and Tables -
Analysis 7.4

Comparison 7 NAPROXEN versus NSAIDS, Outcome 4 SIDE EFFECTS ‐ ALL.

Comparison 8 NSAIDS versus PARACETAMOL, Outcome 1 PAIN RELIEF ‐ SUBJECTIVE.
Figures and Tables -
Analysis 8.1

Comparison 8 NSAIDS versus PARACETAMOL, Outcome 1 PAIN RELIEF ‐ SUBJECTIVE.

Comparison 8 NSAIDS versus PARACETAMOL, Outcome 2 SIDE EFFECTS ‐ GASTRIC.
Figures and Tables -
Analysis 8.2

Comparison 8 NSAIDS versus PARACETAMOL, Outcome 2 SIDE EFFECTS ‐ GASTRIC.

Comparison 8 NSAIDS versus PARACETAMOL, Outcome 3 SIDE EFFECTS ‐ NERVOUS SYSTEM.
Figures and Tables -
Analysis 8.3

Comparison 8 NSAIDS versus PARACETAMOL, Outcome 3 SIDE EFFECTS ‐ NERVOUS SYSTEM.

Study

Comparison

Outcome

No of participants

Aspirin

Other NSAID

Significance

Osathanondh 1985

Aspirin vs Fenoprofen

Mean (SD) pain intensity score post treatment

96 (85 analysed)

1.44 (0.99)

0.79 (0.90)

p = <0.01

Figures and Tables -
Analysis 9.1

Comparison 9 ASPIRIN versus NSAIDS, Outcome 1 PAIN INTENSITY: PARALLEL DESCRIPTIVE DATA.

Comparison 9 ASPIRIN versus NSAIDS, Outcome 2 SIDE EFFECTS ‐ GASTROINTESTINAL.
Figures and Tables -
Analysis 9.2

Comparison 9 ASPIRIN versus NSAIDS, Outcome 2 SIDE EFFECTS ‐ GASTROINTESTINAL.

Comparison 9 ASPIRIN versus NSAIDS, Outcome 3 SIDE EFFECTS ‐ NERVOUS SYSTEM.
Figures and Tables -
Analysis 9.3

Comparison 9 ASPIRIN versus NSAIDS, Outcome 3 SIDE EFFECTS ‐ NERVOUS SYSTEM.

Comparison 9 ASPIRIN versus NSAIDS, Outcome 4 SIDE EFFECTS ‐ ALL.
Figures and Tables -
Analysis 9.4

Comparison 9 ASPIRIN versus NSAIDS, Outcome 4 SIDE EFFECTS ‐ ALL.

Comparison 9 ASPIRIN versus NSAIDS, Outcome 5 ADDITIONAL ANALGESICS REQUIRED.
Figures and Tables -
Analysis 9.5

Comparison 9 ASPIRIN versus NSAIDS, Outcome 5 ADDITIONAL ANALGESICS REQUIRED.

Comparison 9 ASPIRIN versus NSAIDS, Outcome 6 INTERFERENCE WITH DAILY ACTIVITIES.
Figures and Tables -
Analysis 9.6

Comparison 9 ASPIRIN versus NSAIDS, Outcome 6 INTERFERENCE WITH DAILY ACTIVITIES.

Table 1. Doses

Comparison

Study ID

Loading dose

Dose

Aspirin vs placebo

Osathanondh 1985

650mg (4 x day)

Dexketoprofen vs placebo

Ezcurdia 1998

12.5 or 25 (every 6 hours)

Diclofenac sodium vs placebo

Balsamo 1986

75mg suppositories (2 x day)

Diclofenac sodium vs placebo

Kintigh 1995

50mg (3 x day)

Diclofenac sodium vs placebo

Marchini 1995

50mg (4 x day)

Diclofenac sodium vs placebo

Riihiluoma 1981

25mg (3‐6 x day)

Diclofenac sodium vs placebo

Villasenor 1984

100mg

50mg (3 x day)

Etodolac vs placebo

De Souza 1991

200mg (2 x day)

Fenoprofen calcium vs placebo

Arnold 1983

100mg (twice every 4 hrs)

Fenoprofen calcium vs placebo

Osathanondh 1985

100mg or 200mg (4 x day)

Flufenamic acid vs placebo

Kapadia 1978

200mg (3 x day)

Glucamethacin vs Aspirin

Petti 1985

210 mg twice daily

Ibuprofen vs placebo

Arnold 1983

Corson 1978
Dawood 1999
Di Girolamo 1999

Hanson 1982
Marchini 1995

Morrison 1980
Arnold 198Corson 1978
Corson 1978
Dawood 1999
Di Girolamo 1999

Hanson 1982
Marchini 1995

Morrison 1980

200mg (twice every 4 hrs)

Ibuprofen vs placebo

Dawood 1999

400mg (every 4 hrs)

Ibuprofen vs placebo

Di Girolamo 1999

400mg (every 6 hours)

Ibuprofen vs placebo

Hanson 1982

200mg (2 tabs every 4‐8hrs)

Ibuprofen vs placebo

Marchini 1995

400mg (4 x day)

Ibuprofen vs placebo

Morrison 1980

200mg (2 caps, every 4 hrs)

Indomethacin vs placebo

Al Waili 1990

100mg suppositories (1‐3 x day)

Indomethacin vs placebo

Elder 1979

25mg (3 x day)

Indomethacin vs placebo

Kajanoja 1978

25mg (3 x day)

Indomethacin vs placebo

Morrison 1979

25mg (3 x day)

Ketoprofen vs placebo

Ezcurdia 1998

50mg (racemic) (every 6 hours)

Ketoprofen vs placebo

Gleeson 1983

Dose not mentioned (every 4‐6 hours)

Ketoprofen vs placebo

Mehlisch 1990

25mg

25mg, 50mg or 75mg then 25mg 4 x day)

Lysine Cloxinate vs placebo

Di Girolamo 1999

125mg (every 6 hours)

Mefenamic acid vs placebo

Budoff 1979

250mg (4 x day)

Mefenamic acid vs placebo

Powell 1981

250 mg QDS

Naproxen vs placebo

Chan 1983

550mg

275mg (4 x day)

Naproxen vs placebo

Dandenell 1979

250mg as needed

Naproxen vs placebo

Dawood 1999

550mg

275mg (every 4 hrs as needed)

Naproxen vs placebo

Fedele 1989

250mg (3 X day)

Naproxen vs placebo

Hamann 1980

500mg

250mg as needed

Naproxen vs placebo

Hanson 1978

550mg

275mg (every 6hrs)

Naproxen vs placebo

Hanson 1982

550mg

275mg (every 4‐8 hrs)

Naproxen vs placebo

Henzl 1977

550mg

275mg (every 6hrs)

Naproxen vs placebo

Jacobson 1979

250‐500mg

250mg (every 4‐6 hrs)

Naproxen vs placebo

Jacobson 1983

500mg

250mg (every 4‐6 hrs)

275mg (3 x day)

500mgLD, 250mg (4 x day)
550mgLD, 275mg (4 x day)
550mgLD, 275mg (every 6 hrs)
500mg (one dose)

550mgLD, 275mg (every 6 hrs)
500mgLD, 250mg (every 4‐6 hrs)

Naproxen vs placebo

Kintigh 1994

275mg (3 x day)

Naproxen vs placebo

Mehlisch 1990

500mg

250mg (4 x day)

Naproxen vs placebo

Mehlisch 1997

550mg

275mg (4 x day)

Naproxen vs placebo

Pauls 1978

550mg

275mg (every 6 hrs)

Naproxen vs placebo

Sande 1978

550mg

275mg (every 6 hrs)

Niflumic acid vs placebo

Legris 1997

250mg (3 x day)

Nimesulide vs placebo

Moggian 1986

50mg or 100mg (2 x day)

Nimesulide vs placebo

Pulkkinen 1987

100mg (2 x day)

Nimesulide vs placebo

Rondel 1984

200mg per day

Nimesulide vs placebo

Soares 1993

100mg (2 x day)

Piroxicam BCD vs placebo

Dawood 1999

20mg or 40mg (daily)

Piroxicam BCD vs placebo

Costa 1987

20mg (daily suppository)

Piroxicam vs placebo

Akinluyi 1987

20mg (2 tablets a day for 2 days then 1 x day)

Piroxicam vs placebo

Cash 1987

20mg (daily)

Piroxicam vs placebo

Osinusi 1986

20mg (2 tablets a day for 2 days then 1 x day)

Piroxicam vs placebo

Saltveit 1985

20mg (2 tablets a day for 2 days then 1 x day)

Piroxicam vs placebo

Wilhelmsson 1985

20mg (2 tablets a day for 2 days then 1 x day)

Aspirin vs Fenoprofen

Osathanondh 1985

650mg vs 100 or 200mg (4 x day)

Aspirin vs Glucametacin

Petti 1985

500mg vs 210mg (2 x day)

Ibuprofen vs Diclofenac

Marchini 1995

400 vs 50mg (4 x day)

Ibuprofen vs Fenoprofen calcium

Arnold 1983

200mg vs 100mg (twice every 4hrs)

Ibuprofen vs Lysine Cloxinate

Di Girolamo 1999

400 vs 125 mg (every 6 hours

Ibuprofen vs Mefenamic acid

Pedron 1995

200mg vs 500mg (every 8 hrs)

Ibuprofen vs Paracetamol

Layes Molla 1974

200mg vs 500mg (2 caps, 3 x day)

Ibuprofen vs Piroxicam

Pasquale 1988

400mg (4 X daily) vs 3 diff doses

Ibuprofen vs Piroxicam BCD

Dawood 1999

400mg vs 20 or 40mg (4 hourly vs daily)

Indomethacin vs Aspirin

Kajanoja 1978

25mg vs 500mg (3 x day)

Ketoprofen vs Dexketoprofen

Ezcurdia 1998

50 vs 12.5 or 25mg (every 6 hours)

Mefenamic acid vs Fentiazac

Lopez Rosales 1989

500mg (3 x day) vs 100mg (2 x day)

Mefenamic acid vs Nimesulide

Lopez Rosales 1989

500mg (3 x day) vs 100mg (2 x day)

Mefenamic vs Tolfenamic acid

Delgado 1994

500mg vs 200mg (3 x day)

Naproxen vs Diclofenac sodium

Ingemanson 1984

250mg‐1250mg vs 50‐150mg (max daily dose)

Naproxen vs Diclofenac sodium

Kintigh 1995

275mg vs 50mg (3 x day)

Naproxen vs Difusinal

Kajanoja 1984

250mg vs 250mg (4 x day)

Naproxen vs Flurbiprofen

Andersch 1989

500mg vs 100mg (2 x day)

Naproxen vs Ketoprofen

Akerlund 1989

500mg vs 100mg (single dose)

Naproxen vs Ketoprofen

Mehlisch 1990

500mg Naproxen vs 25mg, 50mg or 70mg Ketoprofen

250mg vs 25mg (4 x day)

Naproxen vs Meclofenamate

Benassi 1993

275mg vs 100mg (every 8hrs)

Naproxen vs Piroxicam

Saltveit 1989

500mg Naproxen

250mg vs 20mg (diff doses each day)

Naproxen vs Piroxicam

Wilhelmsson 1985

1000mg vs 40mg (per day)

Naproxen vs Piroxicam BCD

Dawood 1999

550mg Naproxen

275mg (every 4 hrs) vs 20mg or 40mg a day

Naproxen vs Piroxicam BCD

Costa 1987

550mg vs 20mg (daily suppository)

Nimesulide vs Fentiazac

Lopez Rosales 1989

100mg vs 100mg (2 x day)

Piroxicam vs Etodolac

Onatra 1994

20mg (daily) vs 300mg (2 x day)

Figures and Tables -
Table 1. Doses
Table 2. Quality

Study ID

Design

Randomisation

Allocation

Blinding

Group equality

Duration

Follow up

Conflict of interest

Other

Study ID

Design

Randomisation method

Concealment of allocation (to treatment or order of treatment)

Blinding of Participant, clinician & outcome assessment?

Equality of groups with respect to treatment (parallel trials) or treatment order (crossover trials)

Duration of trial

No of participants (proportion followed up)

Potential conflict of interest

Other

Akerlund 1989

Crossover

Not stated

allocated off‐site

Blinding of participant, clinician & outcome assessment

Significantly more baseline pain and lower activity level in Ketoprofen first group

Single oral doses on 2 separate occasions

42 (92%)

None stated

Akinluyi 1987

Crossover

Not stated

Not stated

Blinding of participant, clinician & outcome assessment

Not reported

2 X 2 cycles

60 (100%)

Pharmaceutical company supplied drugs and "showed interest"

No statistical analysis

Al‐Waili 1990

Crossover

Not stated

Pharmacy controlled

Blinding of participant, clinician & outcome assessment

Not reported

2 X 2 cycles

40 (100%)

None stated

Andersch 1989

Crossover

Not stated

Not stated

Blinding of participant, clinician & outcome assessment

Not reported

2 X 2 cycles

60 (95%)

None stated

Arnold 1983

Parallel

Not stated

Not stated

Double blinded: No details given

Yes

4 cycles

166 (86%)

One of researchers employed by pharmaceutical company

Pain relief outcomes reported in ridits and graphs.

Balsamo 1996

Parallel

Not stated

Not stated

Double blinded: No details given

Yes

3 days

40 (No withdrawals mentioned)

None stated

Benassi 1993

Parallel

Not stated

Not stated

Double blinded: No details given

Not reported

5 cycles

30 (No withdrawals mentioned)

None stated

No standard deviations reported for VAS data

Budoff 1979

Crossover

Not stated

Not stated

Double blinded: No details given

Not reported

2 X 3 cycles

46 (96%)

None stated

Cash 1982

Crossover

Not stated

Not stated

Double blinded: No details given

Yes

2X2 months

25 (88%)

Sponsored by pharmaceutical company

Chan 1983

Crossover

Not stated

Not stated

Double blinded: No details given

Not reported

One control cycle then 1 cycle X 2

12 (100%)

Pharmaceutical companies donated drugs

Costa 1987a

Crossover

Not stated

Not stated

Double blinded: No details given

Not reported

1 cycle

12 (No withdrawals mentioned)

One of researchers employed by pharmaceutical company

Day One data in graphical form only, with no SDs

Costa 1987b

Crossover

Not stated

Not stated

Double blinded: No details given

Not reported

1 cycle

14 (No withdrawals mentioned)

One of researchers employed by pharmaceutical company

Day One data in graphical form only, with no SDs

Dandenell 1979

Parallel

Not stated

Not stated

Double blinded: No details given

Yes

2 cycles

97 (89%)

One of researchers employed by pharmaceutical company

Dawood 1999a

Crossover

Computer generated

Not stated

Double blinded: No details given

Not reported

4 X 1 cycle

97 (95%)

Sponsored by pharmaceutical company

Dawood 1999b

Crossover

Computer generated

Unclear

Double blinded: No details given

Not reported

3 X 1 cycle

96 (97%)

Sponsored by pharmaceutical company

De Souza 1991

Parallel

Not stated

Not stated

Double blinded: No details given

Yes

2 X 1 cycle

40 (No withdrawals mentioned)

None stated

Delgado 1994

Crossover

Not stated

Not stated

Double blinded: No details given

Not reported

2 X 3 cycles

80 (91%)

One of researchers employed by pharmaceutical company

Di Girolamo 1999

Crossover

Not stated

Not stated

Double blinded: No details given

Not reported

1 control cycle then 3 X 1 cycles of treatment

24 (100%)

None stated

Elder 1979

Crossover

Not stated

Not stated

Blinding of participant, clinician & outcome assessment

Not reported

3 X 2 cycles

38 (84%)

Pharmaceutical companies donated drugs

Adverse effects reported are those considered "attributable to Indomethacin"

Ezcurdia 1998

Crossover

Computer generated

Not stated

Double blinded: No details given

Not reported

4 X 1 cycles

52 (84% for single dose 25% for other data)

One of researchers employed by pharmaceutical company

Facchinetti 2001

Parallel

Not stated

Not stated

Double blinded: No details given

Yes

2 cycles

308 (98%)

Sponsored by pharmaceutical company

Fedele 1989

Parallel

Not stated

Not stated

Double blinded: No details given

Yes

4 cycles

45 (100%)

None stated.

A further 10 women were randomised to Pirprofen (drug withdrawn)

Gleeson 1983

Crossover

Random numbers table

Not stated

Double blinded: No details given

Not reported

2 X 3 cycles

31 (87%)

None stated

Hamann 1980

Crossover

Not stated

Not stated

Double blinded: No details given

Not reported

2 X 2 cycles

30 (87%)

Pharmaceutical companies donated drugs

Hanson 1978

Parallel

Not stated

Not stated

Double blinded: No details given

Yes

3 cycles

69 (92%)

Partially sponsored by pharmaceutical company

Henzl 1977b

Parallel

Random numbers table

Not stated

Double blinded: No details given

Yes

4 cycles

27 (85%)

One of researchers employed by pharmaceutical company

Ingemanson 1984

Crossover

Not stated

Not stated

Double blinded: No details given

Not reported

2 X 1 cycle

28 (100%)

One of researchers employed by pharmaceutical company

Jacobson 1979

Parallel

Not stated

Not stated

Double blinded: No details given

Mean baseline pain score higher in placebo group; not stated whether difference statistically significant

2 cycles

40 (85%)

One of researchers employed by pharmaceutical company

Jacobson 1983

Crossover

Not stated

Not stated

Double blinded: No details given

Yes

2 X 2 cycles

39 (No withdrawals mentioned)

One of researchers employed by pharmaceutical company

Kajanjoja 1978

Crossover

Not stated

Not stated

Described as double blinded: details given of participant and outcome assessment blinding

Not reported

2 X 3 cycles

47 (100% 4+ cycles, 79% 6 cycles)

Sponsored by pharmaceutical company

Kajanoja 1984

Crossover

Not stated

Not stated

Described as double blinded: details given of participant and outcome assessment blinding

Not reported

2 X 2 cycles of each

22 (86%)

Drugs supplied by pharmaceutical company

Kapadia 1978

Crossover

Not stated

Not stated

Blinding of participant, clinician & outcome assessment

Not reported

2 X 3 cycles

44 (No withdrawals mentioned)

Drugs supplied by pharmaceutical company

Reports those adverse effects "that could have been caused by flufenamic acid"

Kintigh 1995

Parallel

Not stated

Not stated

Double blinded: No details given

Placebo group had significantly smaller percentage of women with severe baseline pain during cycle 2 and for cycles 1 & 2 combined.

2 X 1 cycle

410 (93%)

None stated

No standard deviations for continuous data. Reports those adverse effects "considered to be related to study medication"

Layes Molla 1974

Crossover

Not stated

Not stated

Double blinded: No details given

Yes

2 X 1 cycle

67 (89%)

Drugs supplied by pharmaceutical company

Legris 1997

Crossover

Not stated

Not stated

Double blinded: No details given

Only statistically significant difference was cycle length ‐ longer in the group that received Niflumic acid first

2 X 1 cycle

69 (90%)

One of researchers affiliated to pharmaceutical company

Lopez Rosales 1989

Parallel

Not stated

Not stated

Blinding of participant, clinician & outcome assessment

Not reported

3 X 3 cycles

40 (100%)

Non stated

20 additional participants were on Fentiazac (now withdrawn)

Marchini 1995

Crossover

Not stated

Not stated

Double blinded: No details given

Not reported

3 X 1 cycle

60 (93%)

Two of researchers affiliated to pharmaceutical company

Mehlisch 1990

Crossover

Not stated

Not stated

Double blinded: No details given

Yes

3 X 1 cycle

70 (86%)

Sponsored by pharmaceutical company

No standard deviations for continuous data

Mehlisch 1997

Crossover

Not stated

Not stated

Double blinded: No details given

Not reported

3 X 1 cycle

57 (89%)

One of researchers affiliated to pharmaceutical company

One of 3 study drugs not included in review (withdrawn)

Milsom 1985

Crossover

Not stated

Not stated

Blinding of participant, clinician & outcome assessment

Yes

2 X 2 cycles

60 (95%)

None stated

Specifies sources of funding (academic institutions). Reports those adverse effects "which could be attributed to the use of the given treatment"

Milsom 2002d

Crossover

Computer generated

Assigned coded medications at enrolment

Double blinded: no further details given

Yes

1 X 2 cycles

98 (84%)

One of researchers affiliated to pharmaceutical company

Milsom 2002e

Crossover

Computer generated

Assigned coded medications at enrolment

Double blinded: no further details given

Yes

1 X 2 cycles

82 (94%)

One of researchers affiliated to pharmaceutical company

Moggian 1986

Crossover

Not stated

Double blinded: No details given

Yes

3 cycles (one or two of which on active drug)

67 (82%)

None stated

Morrison 1979

Parallel

Not stated

Double blinded: No details given

Yes

4 cycles

32 (No withdrawals mentioned)

None stated

Morrison 1980

Crossover

Not stated

Double blinded: No details given

Yes

3 X 1 cycle

55 (93%)

One of researchers affiliated to pharmaceutical company

One of 3 study drugs not included in review (narcotic)

Onatra 1994

Crossover

Not stated

Double blinded: No details given

Baseline pain more severe in Piroxicam group: not stated if difference statistically significant

2 X 2 cycles

31 (No withdrawals mentioned)

None stated

Osathanondh 1985

Parallel

Unclear

Double blinded: No details given

Not stated

4 cycles

96 (88%)

Sponsored by pharmaceutical company

Osinusi 1986

Crossover

Not stated

Double blinded: No details given

Not stated

2 X 2 cycles

50 (94%)

Drugs provided by pharmaceutical company

Pasquale 1988

Parallel

Computer generated

Double blinded: No details given

Not stated

1 cycle

74 (92%)

Statistician affiliated to pharmaceutical company

No SDs for continuous data.

Pauls 1978

Parallel

Not stated

Double blinded: No details given

Yes

3 cycles

17 (100%)

None stated

Pedron 1995

Parallel

Not stated

Double blinded: No details given

Yes

2 cycles

60 (No withdrawals mentioned)

None stated

Petti 1985

Crossover

Not stated

Double blinded: No details given

Not stated

2 X 1 cycle

33 (94%)

None stated

Powell 1981

Crossover

Not stated

Double blinded: No details given

Not stated

2 X 3 cycles

77 (90%)

None stated

Data on adverse effects includes only reactions "considered by the investigator as attributable to study medications"

Pulkkinen 1987

Crossover

Sealed opaque sequentially numbered envelopes

Double blinded: No details given

Not stated

2 X 2 cycles

14 (93%)

Pharmaceutical company provided drugs and assistance in interpreting the data

Riihiluoma 1981

Crossover

Not stated

Double blinded: No details given

Not stated

2 X 2 cycles

35 (82%)

Drugs supplied by pharmaceutical company

Rondel 1984

Crossover

Not stated

Double blinded: No details given

Not stated

2 X 2 cycles

12 (100%)

Pharmaceutical company provided drugs and assistance in interpreting the data

Saltveit 1985

Crossover

Not stated

Double blinded: No details given

Not stated

2 X 2 cycles

92 (98%)

Supported by pharmaceutical company

Saltveit 1989

Crossover

Not stated

Double blinded: No details given

Not stated

2 X 2 cycles

198 (88%)

None stated

No standard deviations reported

Sande 1978

Parallel

Not stated

Double blinded: No details given

Yes

3 cycles

37 (86%)

One of researchers affiliated to pharmaceutical company

Soares 1993

Parallel

Not stated

Double blinded: No details given

Not stated

2 X 1 cycle

49 (93%)

None stated

Villasenor 1984

Parallel

Random numbers table

Double blinded: No details given

Diclofenac group older with longer history of dysmenorrhoea: not stated whether differences were statistically significant

1 cycle

40 (No withdrawals mentioned)

None stated

Wilhelmsson 1985A

Crossover

Not stated

Double blinded: No details given

Not stated

2 X 1 cycle

83 (No withdrawals mentioned)

Not stated.

Wilhelmsson 1985B

Crossover

Not stated

Double blinded: No details given

Not stated

2 X 1 cycle

23 (100%)

Not stated

Figures and Tables -
Table 2. Quality
Table 3. Pain relief: NSAIDs vs placebo (Crossover data)

Comparison

Study ID

No of participants

Outcome measure

NSAID

Placebo

Significance

Note

Aspirin vs placebo

Kajanoja 1978

47

No of cycles where treatment gave moderate/good relief

13/89

9/90

Not statistically significant

Diclofenac vs placebo

Marchini 1995

60

No of women reporting good/excellent efficacy

37/56

30/57

Not statistically significant

Paired analysis

Diclofenac vs placebo

Riihiluoma 1981

35

No of cycles when pain much improved

14/58

3/57

p<0.05

Etodolac vs placebo

De Souza 1991

40

Moderate or excellent pelvic pain relief

28/40

14/40

p<0.005

Paired analysis

Flufenamic acid vs placebo

Kapadia 1978

44

Mean pain relief score (SD)

6.18 (3.05)

1.54 (2.38)

p<0.001

Paired analysis

Ibuprofen vs placebo

Dawood 1999b

96

No of women reporting very good/excellent efficacy

39/84

14/86

Not reported

Ibuprofen vs placebo

Marchini 1995

60

No of women reporting good or excellent efficacy

33/56

30/57

Not statistically significant

Paired analysis

Ibuprofen vs placebo

Morrison 1980

55

Moderate to complete pain relief

41/51

10/51

p<0.0001

Paired analysis

Indomethacin vs placebo

al‐Waili 1990

40

No of women with moderate to complete relief

36/40

5/40

p<0.05

Indomethacin vs placebo

Elder 1979

38 (32 analysed)

Mean pain relief score [max 9] and (standard deviation)

6.2 (3.3)

1.6 (2.2)

p<0.01

Indomethacin vs placebo

Kajanoja 1978

37

No of cycles when women reported moderate/good relief

42/90

9/90

p<0.001

Ketoprofen vs placebo

Gleeson 1983

31

No of women with at least moderate pain relief

22/27

10/27

p<0.001

Paired analysis

Ketoprofen vs placebo

Mehlisch 1990

70 (60 analysed)

No of women rating efficacy as good/excellent after first dose

28/36

11/36

p =/< 0.05

Paired analysis. Women assigned to 3 of possible 5 regimens

Lysine Clonixinate vs placebo

Di Girolamo 1999

24

No of women with total pain relief

10/24

2/24

p<0.001

Paired analysis

Naproxen vs placebo

Chan 1983

12

No of women with at least moderate pain relief

11/12

2/12

p<0.01

Paired analysis

Naproxen vs placebo

Dawood 1999a

97

No of women rating treatment very good or excellent

25/87

10/84

Not reported

Naproxen vs placebo

Hamann 1980

30

No of women reporting relief of cramping

23/26

5/26

p = 0.0006

Paired analysis

Naproxen vs placebo

Jacobson 1983

39

No of women with at least moderate relief

5/39

0/39

p = 0.0005

Naproxen vs placebo

Mehlisch 1990

70 (60 analysed)

No of women rating efficacy as good/excellent after first dose

22/36

11/36

p =/< 0.05

Paired analysis. Women assigned to 3 of possible 5 regimens

Naproxen vs placebo

Mehlisch 1997

57 (51 analysed)

Effectiveness of treatment (standard error)

3.10 (SE 0.159)

2.02 (SE 0.160)

p = 0.0001

Paired analysis

Nimesulide vs placebo

Pulkkinen 1987

14

No of cycles where women rated therapy good/ very effective

22/28

9/27

p<0.01

Nimesulide vs placebo

Rondel 1984

12

No of cycles where women rated therapy good/ very effective

10/12

2/12

p<0.01

Paired analysis

Piroxicam vs placebo

Wilhelmsson 1985B

23

No of women with good or very good pain relief

18/21

5/21

p<0.001

Figures and Tables -
Table 3. Pain relief: NSAIDs vs placebo (Crossover data)
Table 4. Pain relief: NSAIDs vs NSAIDs (Crossover data)

NSAID 1

NSAID 2

Study ID

No of participants

Outcome measure

NSAID 1

NSAID 2

Significance

Aspirin

Indomethacin

Kajanoja 1978

47

No of cycles where treatment gave moderate/good relief

13/89

42/90

p = <0.001

Aspirin

Glucamethacin

Petti 1985

33

No of women with marked improvement or painfree

12/30

19/30

Not recorded

Naproxen

Diclofenac

Ingemanson 1984

28

Mean duration of pain relief on five point scale (standard error)

4.3 (0.51)

4.4 (0.45)

Not statistically significant

Naproxen

Diflunisal

Kajanoja 1984

22 (19 analysed)

No of cycles where treatment achieved moderate/good relief

34/38

28/38 cycles

Not statistically significant

Naproxen

Flurbiprofen

Andersch 1989

60

No of women with >2 point pain relief on 0‐5 point scale

6/57

8/57

Not statistically significant

Naproxen

Ibuprofen

Milsom 1985

60

No of women with moderate/complete pain relief

5/57

6/57

Not statistically significant

Naproxen

Piroxicam

Dawood 1999A

97

No of women with very good/excellent relief

25/87

33/83

Not reported

Naproxen

Piroxicam

Wilhelmsson 1985A

83

No of women rating day one treatment as good or very good

45/69

49/69

Not statistically significant

Naproxen

Ketoprofen

Mehlisch 1990

70 (60 analysed)

No of women rating efficacy as good/excellent after first dose

22/36

28/36

Not statistically significant

Ibuprofen

Lysine Clonixinate

Di Girolamo 1999

24

Complete symptom relief

9/24

10/24

Not statistically significant

Ibuprofen

Piroxicam

Dawood 1999B

97

No of women rating treatment very good or excellent

39/84

41/87

Not reported

Ibuprofen

Diclofenac

Marchini 1995

60

No of women rating efficacy good or excellent

33/56

37/56

Not statistically significant

Figures and Tables -
Table 4. Pain relief: NSAIDs vs NSAIDs (Crossover data)
Table 5. Gastrointestinal adverse effects: NSAIDS vs placebo (Crossover data)

Comparison

Study ID

No of participants

NSAID

Placebo

Significance

Indomethacin vs placebo

al‐Waili 1990

40

3/40

0/40

Not reported

Indomethacin vs placebo

Kajanoja 1978

47

3/47

6/47

Not reported

Ketoprofen vs placebo

Ezcurdia 1998

52

2/46

0/49

Not statistically significant

Ketoprofen vs placebo

Gleeson 1983

31

2/27

3/27

Not reported

Mefenamic acid vs placebo

Powell 1981

77

1/69

8/69

Not reported

Naproxen vs placebo

Jacobson 1983

39

1/39

0/39

Not statistically significant

Naproxen vs placebo

Mehlisch 1997

57

7/53

3/51

Not statistically significant

Piroxicam vs placebo

Costa 1987a

12

0/6

0/6

Not statistically significant

Piroxicam vs placebo

Akinluyi 1987

60

4/60

5/60

Not statistically significant

Piroxicam vs placebo

Cash 1982

25

1/22

1/22

Not statistically significant

Figures and Tables -
Table 5. Gastrointestinal adverse effects: NSAIDS vs placebo (Crossover data)
Table 6. Nervous system adverse effects: NSAIDS vs placebo (Crossover data)

Comparison

Study ID

No of participants

NSAID

Placebo

Significance

Indomethacin vs placebo

Kajanoja 1978

47

14/47

2/47

Not reported

Naproxen vs placebo

Jacobson 1983

39

6/39

0/39

Not reported

Piroxicam vs placebo

Akinluyi 1987

60

1/60

1/60

Not statistically significant

Mefenamic acid vs placebo

Powell 1981

77

7/69

4/69

Not reported

Figures and Tables -
Table 6. Nervous system adverse effects: NSAIDS vs placebo (Crossover data)
Table 7. ALL adverse effects: NSAIDs vs placebo (Crossover data)

Comparison

Study ID

No of participants

NSAID

Placebo

Significance

Notes

Diclofenac vs placebo

Marchini 1995

60

7/60

1/60

Not reported

Etodolac vs placebo

De Souza 1991

40

5/40

4/40

Not statistically significant

Ibuprofen vs placebo

Marchini 1995

60

2/60

1/60

Not reported

Ibuprofen vs placebo

Morrison 1980

55

0/51

1/51

Not reported

Ketoprofen vs placebo

Ezcurdia 1998

52

8/46

5/49

Not statistically significant

Ketoprofen vs placebo

Gleeson 1983

31

7/27

14/27

Not reported

Ketoprofen vs placebo

Mehlisch 1990

70 (60 analysed)

10/36

4/37

Not statistically significant

Women received 3 of 5 possible treatments

Naproxen vs placebo

Mehlisch 1990

70 (60 analysed)

9/37

4/37

Not statistically significant

Women received 3 of 5 possible treatments

Naproxen vs placebo

Mehlisch 1997

57

20/53

19/51

Not statistically significant

Piroxicam vs placebo

Dawood 1999A

97

13/93

7/93

Not reported

Piroxicam vs placebo

Dawood 1999B

96

7/93

4/93

Not reported

Piroxicam vs placebo

Saltveit 1985

92

12/90

11/90

Not statistically significant

Piroxicam vs placebo

Wilhelmsson 1985B

23

2/21

4/21

Not reported

Figures and Tables -
Table 7. ALL adverse effects: NSAIDs vs placebo (Crossover data)
Table 8. Gastrointestinal side effects: NSAIDs vs NSAIDs (Crossover data)

NSAID 1

NSAID 2

Study ID

No of participants

NSAID 1

NSAID 2

Significance

Aspirin

Glucamethacin

Petti 1985

33

4/33

5/33

Not reported

Aspirin

Indomethacin

Kajanoja 1978

47

3/47

7/47

Not reported

Naproxen

Flurbiprofen

Andersch 1989

60

4/57

3/57

Not statistically significant

Naproxen

Ketoprofen

Akerlund 1989

42

1/39

2/39

Not reported

Naproxen

Piroxicam

Wilhelmsson 1985A

83

5/69

5/69

Not statistically significant

Mefenamic acid

Tolfenamic acid

Delgado 1994

80

3/74

4/73

Not statistically significant

Figures and Tables -
Table 8. Gastrointestinal side effects: NSAIDs vs NSAIDs (Crossover data)
Table 9. Nervous system adverse effects: NSAIDs vs NSAIDs (Crossover data)

NSAID 1

NSAID 2

Study ID

No of participants

NSAID 1

NSAID 2

Significance

Naproxen

Diclofenac

Ingemanson 1984

28

2/28

3/28

Not statistically significant

Naproxen

Flurbiprofen

Andersch 1989

60

7/57

5/57

Not statistically significant

Naproxen

Ketoprofen

Akerlund 1989

42

2/39

1/39

Not reported

Naproxen

Piroxicam

Wilhelmsson 1985A

83

2/69

5/69

Not reported

Figures and Tables -
Table 9. Nervous system adverse effects: NSAIDs vs NSAIDs (Crossover data)
Table 10. ALL adverse effects: NSAIDs vs NSAIDs (Crossover data)

NSAID 1

NSAID 2

Study ID

No of participants

NSAID 1

NSAID 2

Significance

Notes

Aspirin

Glucamethacin

Petti 1985

33

4/33

5/33

Not reported

Diclofenac

Ibuprofen

Marchini 1995

60

7/60

2/60

Not reported

Ibuprofen

Piroxicam

Dawood 1999B

96

8/93

7/93

Not reported

Mefenamic acid

Tolfenamic acid

Delgado 1994

80

3/73

4/73

Not statistically significant

Naproxen

Diclofenac

Ingemanson 1984

28

2/28

4/28

Not statistically significant

Naproxen

Flurbiprofen

Andersch 1989

60

11/57

9/57

Not statistically significant

Naproxen

Ketoprofen

Akerlund 1989

42

2/39

1/39

Not reported

Naproxen

Piroxicam

Dawood 1999A

97

10/93

13/93

Not reported

Naproxen

Piroxicam

Saltveit 1989

198

24/198

20/198

Not statistically significant

Naproxen

Piroxicam

Wilhelmsson 1985A

83

8/69

11/69

Not reported

Naproxen

Ketoprofen

Mehlisch 1990

70 (60 analysed)

9/37

10/36

Not statistically significant

Women received 3 of 5 possible treatments

Piroxicam

Etodolac

Onatra 1994

31

1/31

1/31

Not statistically significant

Figures and Tables -
Table 10. ALL adverse effects: NSAIDs vs NSAIDs (Crossover data)
Table 11. ALL adverse effects: NSAIDs vs Paracetamol (Crossover data)

Comparison

Study ID

No of participants

NSAID

Paracetamol

Significance

Ibuprofen vs Paracetamol

Layes Molla 1974

67

8/67

9/67

Not statistically significant

Figures and Tables -
Table 11. ALL adverse effects: NSAIDs vs Paracetamol (Crossover data)
Table 12. Additional analgesics required: NSAIDs vs placebo or NSAIDs (Crossover data)

NSAID 1

Comparison

Study ID

No of participants

NSAID 1

Comparison

Significance

Ibuprofen

Placebo

Morrison 1980

55

7/51

33/51

p<0.001

Naproxen

Piridoxine

Dawood 1999A

97

10/93

10/93

Not statistically significant

Naproxen

Flurbiprofen

Andersch 1989

60

5/57

8/57

Not reported

Figures and Tables -
Table 12. Additional analgesics required: NSAIDs vs placebo or NSAIDs (Crossover data)
Table 13. Interference with everyday life: NSAIDS vs placebo (Crossover data)

Comparison

Study ID

No of participants

Outcome measure

NSAID

Placebo

Significance

Naproxen vs placebo

Jacobson 1983

39

No of women with interference

13/39

18/39

Not statistically significant

Ibuprofen vs placebo

Morrison 1980

55

No of women unable to pursue normal activities

2/51

20/51

p<0.001

Figures and Tables -
Table 13. Interference with everyday life: NSAIDS vs placebo (Crossover data)
Table 14. Interference with everyday life: NSAIDS vs NSAIDS (Crossover data)

Comparison

Study ID

No of participants

Outcome measure

NSAID 1

NSAID 2

Significance

Naproxen vs Flurbiprofen

Andersch 1989

57

Number with interference

42/57

51/57

Not reported

Naproxen vs Ibuprofen

Milsom 1985

60

Women with any level of interference

43/57

43/57

Not statistically significant

Figures and Tables -
Table 14. Interference with everyday life: NSAIDS vs NSAIDS (Crossover data)
Table 15. Pain relief: NSAIDs vs Paracetamol (Crossover data)

Comparison

Study ID

No of participants

Outcome measure

NSAID

Paracetamol

Significance

Ibuprofen vs paracetamol

Layes Molla 1974

67

No of women with at least moderate pain relief

44/60

38/60

Not statistically significant

Figures and Tables -
Table 15. Pain relief: NSAIDs vs Paracetamol (Crossover data)
Table 16. Absence from work/school: NSAIDs vs placebo (Crossover data)

Comparison

Study ID

No of participants

Outcome measure

NSAID

Placebo

Significance

Akinluyi 1987

Akinluyi 1987

60

No of cycles in which women needed days off work

6/80

54/80

Not reported

Figures and Tables -
Table 16. Absence from work/school: NSAIDs vs placebo (Crossover data)
Table 17. Absence from work/school: NSAIDS VS NSAIDS (Crossover data)

Comparison

Study ID

No of participants

Outcome measure

NSAID 1

NSAID 2

Significance

Naproxen vs Flurbiprofen

Andersch 1989

60

No of women requiring time off work

6/57

3/57

Not reported

Naproxen vs Ibuprofen

Milsom 1985

60

No of women absent from work

6/57

8/57

Not statistically significant

Figures and Tables -
Table 17. Absence from work/school: NSAIDS VS NSAIDS (Crossover data)
Comparison 1. NSAIDS versus PLACEBO

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 PAIN RELIEF ‐ SUBJECTIVE Show forest plot

14

599

Peto Odds Ratio (Peto, Fixed, 95% CI)

7.91 [5.65, 11.09]

1.1 Diclofenac vs placebo

2

80

Peto Odds Ratio (Peto, Fixed, 95% CI)

15.05 [6.15, 36.83]

1.2 Indomethacin vs placebo

1

32

Peto Odds Ratio (Peto, Fixed, 95% CI)

23.59 [6.01, 92.53]

1.3 Mefenamic acid vs placebo

1

44

Peto Odds Ratio (Peto, Fixed, 95% CI)

7.32 [2.26, 23.71]

1.4 Naproxen vs placebo

7

287

Peto Odds Ratio (Peto, Fixed, 95% CI)

6.74 [4.08, 11.12]

1.5 Niflumic acid vs placebo

1

59

Peto Odds Ratio (Peto, Fixed, 95% CI)

2.00 [0.61, 6.57]

1.6 Nimesulide vs placebo

1

37

Peto Odds Ratio (Peto, Fixed, 95% CI)

3.97 [1.10, 14.34]

1.7 Piroxicam vs placebo

1

60

Peto Odds Ratio (Peto, Fixed, 95% CI)

16.14 [5.89, 44.25]

2 PAIN INTENSITY: PARALLEL DESCRIPTIVE DATA Show forest plot

Other data

No numeric data

3 ADVERSE EFFECTS ‐ GASTROINTESTINAL Show forest plot

7

432

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.70 [0.89, 3.25]

3.1 Aspirin vs placebo

1

36

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.91 [0.39, 9.26]

3.2 Fenoprofen vs placebo

1

49

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.16 [0.22, 6.12]

3.3 Indomethacin vs placebo

1

32

Peto Odds Ratio (Peto, Fixed, 95% CI)

3.03 [0.38, 23.79]

3.4 Mefenamic acid vs placebo

1

44

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.90 [0.16, 4.96]

3.5 Naproxen vs placebo

4

271

Peto Odds Ratio (Peto, Fixed, 95% CI)

2.01 [0.75, 5.39]

4 ADVERSE EFFECTS ‐ NERVOUS SYSTEM Show forest plot

4

229

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.82 [0.76, 4.32]

4.1 Aspirin vs placebo

1

36

Peto Odds Ratio (Peto, Fixed, 95% CI)

3.66 [0.75, 17.71]

4.2 Fenoprofen vs placebo

1

49

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.60 [0.22, 11.45]

4.3 Indomethacin vs placebo

1

32

Peto Odds Ratio (Peto, Fixed, 95% CI)

2.04 [0.20, 21.17]

4.4 Naproxen vs placebo

2

112

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.05 [0.25, 4.36]

5 ADVERSE EFFECTS ‐ ALL Show forest plot

9

1030

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.52 [1.09, 2.12]

5.1 Aspirin vs placebo

1

36

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.93 [0.49, 7.62]

5.2 Diclofenac vs placebo

3

326

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.85 [0.74, 4.61]

5.3 Fenoprofen vs placebo

2

162

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.10 [0.58, 2.09]

5.4 Ibuprofen vs placebo

1

110

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.56 [0.74, 3.30]

5.5 Naproxen vs placebo

4

330

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.59 [0.85, 2.94]

5.6 Niflumic acid vs placebo

1

66

Peto Odds Ratio (Peto, Fixed, 95% CI)

2.53 [0.67, 9.62]

6 ADDITIONAL ANALGESICS REQUIRED Show forest plot

10

667

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.33 [0.23, 0.47]

6.1 Aspirin vs placebo

1

36

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.72 [0.18, 2.84]

6.2 Fenoprofen vs placebo

2

133

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.66 [0.23, 1.91]

6.3 Ibuprofen vs placebo

2

109

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.49 [0.15, 1.66]

6.4 Mefenamic acid vs placebo

1

69

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.60 [0.23, 1.52]

6.5 Naproxen vs placebo

6

267

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.22 [0.13, 0.35]

6.6 Piroxicam vs placebo

1

53

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.25 [0.06, 1.16]

7 INTERFERENCE WITH DAILY ACTIVITIES Show forest plot

3

216

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.36 [0.20, 0.64]

7.1 Aspirin vs placebo

1

36

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.44 [0.11, 1.74]

7.2 Fenoprofen vs placebo

1

49

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.21 [0.05, 0.90]

7.3 Naproxen vs placebo

2

131

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.38 [0.19, 0.78]

8 ABSENCE FROM WORK/SCHOOL Show forest plot

4

229

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.20 [0.12, 0.34]

8.1 Diclofenac vs placebo

1

34

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.07 [0.01, 0.32]

8.2 Naproxen vs placebo

3

195

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.23 [0.13, 0.40]

Figures and Tables -
Comparison 1. NSAIDS versus PLACEBO
Comparison 2. ASPIRIN versus NSAIDS

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 PAIN INTENSITY: PARALLEL DESCRIPTIVE DATA Show forest plot

Other data

No numeric data

2 SIDE EFFECTS ‐ GASTROINTESTINAL Show forest plot

1

Peto Odds Ratio (Peto, Fixed, 95% CI)

Subtotals only

2.1 Aspirin vs Fenoprofen

1

61

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.77 [0.53, 5.94]

3 SIDE EFFECTS ‐ NERVOUS SYSTEM Show forest plot

1

Peto Odds Ratio (Peto, Fixed, 95% CI)

Subtotals only

3.1 Aspirin vs Fenoprofen

1

61

Peto Odds Ratio (Peto, Fixed, 95% CI)

3.20 [0.92, 11.10]

4 SIDE EFFECTS ‐ ALL Show forest plot

1

61

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.46 [0.52, 4.07]

4.1 Aspirin vs Fenoprofen

1

61

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.46 [0.52, 4.07]

5 ADDITIONAL ANALGESICS REQUIRED Show forest plot

1

Peto Odds Ratio (Peto, Fixed, 95% CI)

Subtotals only

5.1 Aspirin vs Fenoprofen

1

61

Peto Odds Ratio (Peto, Fixed, 95% CI)

2.06 [0.73, 5.85]

6 INTERFERENCE WITH DAILY ACTIVITIES Show forest plot

1

Peto Odds Ratio (Peto, Fixed, 95% CI)

Subtotals only

6.1 Aspirin vs Fenoprofen

1

61

Peto Odds Ratio (Peto, Fixed, 95% CI)

2.57 [0.81, 8.19]

Figures and Tables -
Comparison 2. ASPIRIN versus NSAIDS
Comparison 3. DICLOFENAC Versus NSAIDS

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 RELIEF OF PAIN ‐ SUBJECTIVE Show forest plot

1

304

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.69 [0.38, 1.25]

1.1 Diclofenac vs Nimesulide

1

304

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.69 [0.38, 1.25]

2 ADVERSE EFFECTS ‐ GASTROINTESTINAL Show forest plot

Other data

No numeric data

2.1 Diclofenac vs Nimesulide

Other data

No numeric data

Figures and Tables -
Comparison 3. DICLOFENAC Versus NSAIDS
Comparison 4. FENOPROFEN versus NSAIDS

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 PAIN INTENSITY: PARALLEL DESCRIPTIVE DATA Show forest plot

Other data

No numeric data

2 SIDE EFFECTS ‐ ALL Show forest plot

2

172

Odds Ratio (M‐H, Fixed, 95% CI)

0.67 [0.36, 1.23]

2.1 Fenoprofen vs Aspirin

1

61

Odds Ratio (M‐H, Fixed, 95% CI)

0.68 [0.24, 1.92]

2.2 Fenoprofen vs Ibuprofen

1

111

Odds Ratio (M‐H, Fixed, 95% CI)

0.66 [0.31, 1.40]

Figures and Tables -
Comparison 4. FENOPROFEN versus NSAIDS
Comparison 5. IBUPROFEN versus NSAIDS

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 PAIN RELIEF ‐ SUBJECTIVE Show forest plot

1

81

Odds Ratio (M‐H, Fixed, 95% CI)

0.57 [0.23, 1.38]

1.1 Ibuprofen vs Naproxen

1

81

Odds Ratio (M‐H, Fixed, 95% CI)

0.57 [0.23, 1.38]

2 SIDE EFFECTS ‐ GASTROINTESTINAL Show forest plot

1

87

Odds Ratio (M‐H, Fixed, 95% CI)

1.5 [0.24, 9.45]

2.1 Ibuprofen vs Naproxen

1

87

Odds Ratio (M‐H, Fixed, 95% CI)

1.5 [0.24, 9.45]

3 SIDE EFFECTS ‐ NERVOUS SYSTEM Show forest plot

1

87

Odds Ratio (M‐H, Fixed, 95% CI)

0.19 [0.01, 4.00]

3.1 Ibuprofen vs Naproxen

1

87

Odds Ratio (M‐H, Fixed, 95% CI)

0.19 [0.01, 4.00]

4 SIDE EFFECTS ‐ ALL Show forest plot

1

Peto Odds Ratio (Peto, Fixed, 95% CI)

Subtotals only

4.1 Ibuprofen versus Fenoprofen

1

111

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.51 [0.72, 3.18]

5 ADDITIONAL ANALGESICS REQUIRED Show forest plot

2

167

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.80 [0.29, 2.26]

5.1 Ibuprofen vs Piroxicam

1

56

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.76 [0.15, 3.76]

5.2 Ibuprofen vs Fenoprofen

1

111

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.83 [0.21, 3.24]

Figures and Tables -
Comparison 5. IBUPROFEN versus NSAIDS
Comparison 6. MEFENAMIC ACID versus NSAIDS

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 PAIN INTENSITY ‐ VAS Show forest plot

1

73

Mean Difference (IV, Fixed, 95% CI)

0.23 [‐0.64, 1.10]

1.1 Mefenamic acid vs Tolfenamic acid

1

73

Mean Difference (IV, Fixed, 95% CI)

0.23 [‐0.64, 1.10]

2 PAIN INTENSITY ‐ NON VAS SCALE Show forest plot

Other data

No numeric data

2.1 Mefenamic acid vs Nimesulide

Other data

No numeric data

3 INTERFERENCE WITH DAILY ACTIVITIES Show forest plot

1

73

Mean Difference (IV, Fixed, 95% CI)

0.54 [‐0.36, 1.44]

3.1 Mefenamic acid vs tolfenamic acid

1

73

Mean Difference (IV, Fixed, 95% CI)

0.54 [‐0.36, 1.44]

Figures and Tables -
Comparison 6. MEFENAMIC ACID versus NSAIDS
Comparison 7. NAPROXEN versus NSAIDS

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 PAIN RELIEF‐ SUBJECTIVE Show forest plot

1

81

Odds Ratio (M‐H, Fixed, 95% CI)

1.77 [0.72, 4.32]

1.1 Naproxen vs Ibuprofen

1

81

Odds Ratio (M‐H, Fixed, 95% CI)

1.77 [0.72, 4.32]

2 SIDE EFFECTS ‐ GASTROINTESTINAL Show forest plot

2

117

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.02 [0.24, 4.22]

2.1 Naproxen vs Ibuprofen

1

87

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.67 [0.11, 4.06]

2.2 Naproxen vs Meclofenamate sodium

1

30

Peto Odds Ratio (Peto, Fixed, 95% CI)

2.05 [0.20, 21.36]

3 SIDE EFFECTS ‐ NERVOUS SYSTEM Show forest plot

2

117

Peto Odds Ratio (Peto, Fixed, 95% CI)

7.62 [0.79, 73.95]

3.1 Naproxen vs Ibuprofen

1

87

Peto Odds Ratio (Peto, Fixed, 95% CI)

7.75 [0.48, 125.88]

3.2 Naproxen vs Meclofenamate sodium

1

30

Peto Odds Ratio (Peto, Fixed, 95% CI)

7.39 [0.15, 372.38]

4 SIDE EFFECTS ‐ ALL Show forest plot

2

323

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.09 [0.54, 2.22]

4.1 Naproxen vs Meclofenamate sodium

1

30

Peto Odds Ratio (Peto, Fixed, 95% CI)

3.05 [0.38, 24.18]

4.2 Naproxen vs Diclofenac

1

293

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.96 [0.45, 2.03]

Figures and Tables -
Comparison 7. NAPROXEN versus NSAIDS
Comparison 8. NSAIDS versus PARACETAMOL

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 PAIN RELIEF ‐ SUBJECTIVE Show forest plot

1

68

Odds Ratio (M‐H, Fixed, 95% CI)

2.25 [0.81, 6.19]

1.1 Naproxen vs Paracetamol

1

68

Odds Ratio (M‐H, Fixed, 95% CI)

2.25 [0.81, 6.19]

2 SIDE EFFECTS ‐ GASTRIC Show forest plot

1

78

Odds Ratio (M‐H, Fixed, 95% CI)

1.0 [0.06, 16.58]

2.1 Naproxen vs Paracetamol

1

78

Odds Ratio (M‐H, Fixed, 95% CI)

1.0 [0.06, 16.58]

3 SIDE EFFECTS ‐ NERVOUS SYSTEM Show forest plot

1

78

Odds Ratio (M‐H, Fixed, 95% CI)

1.54 [0.24, 9.78]

3.1 Naproxen vs Paracetamol

1

78

Odds Ratio (M‐H, Fixed, 95% CI)

1.54 [0.24, 9.78]

Figures and Tables -
Comparison 8. NSAIDS versus PARACETAMOL
Comparison 9. ASPIRIN versus NSAIDS

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 PAIN INTENSITY: PARALLEL DESCRIPTIVE DATA Show forest plot

Other data

No numeric data

2 SIDE EFFECTS ‐ GASTROINTESTINAL Show forest plot

1

Peto Odds Ratio (Peto, Fixed, 95% CI)

Subtotals only

2.1 Aspirin vs Fenoprofen

1

61

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.77 [0.53, 5.94]

3 SIDE EFFECTS ‐ NERVOUS SYSTEM Show forest plot

1

Peto Odds Ratio (Peto, Fixed, 95% CI)

Subtotals only

3.1 Aspirin vs Fenoprofen

1

61

Peto Odds Ratio (Peto, Fixed, 95% CI)

3.20 [0.92, 11.10]

4 SIDE EFFECTS ‐ ALL Show forest plot

1

61

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.46 [0.52, 4.07]

4.1 Aspirin vs Fenoprofen

1

61

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.46 [0.52, 4.07]

5 ADDITIONAL ANALGESICS REQUIRED Show forest plot

1

Peto Odds Ratio (Peto, Fixed, 95% CI)

Subtotals only

5.1 Aspirin vs Fenoprofen

1

61

Peto Odds Ratio (Peto, Fixed, 95% CI)

2.06 [0.73, 5.85]

6 INTERFERENCE WITH DAILY ACTIVITIES Show forest plot

1

Peto Odds Ratio (Peto, Fixed, 95% CI)

Subtotals only

6.1 Aspirin vs Fenoprofen

1

61

Peto Odds Ratio (Peto, Fixed, 95% CI)

2.57 [0.81, 8.19]

Figures and Tables -
Comparison 9. ASPIRIN versus NSAIDS