Agentes antiinflamatorios no esteroideos para inducir la regresión y prevenir la progresión de la neoplasia intraepitelial cervical
Información
- DOI:
- https://doi.org/10.1002/14651858.CD004121.pub4Copiar DOI
- Base de datos:
-
- Cochrane Database of Systematic Reviews
- Versión publicada:
-
- 12 febrero 2018see what's new
- Tipo:
-
- Intervention
- Etapa:
-
- Review
- Grupo Editorial Cochrane:
-
Grupo Cochrane de Cáncer ginecológico, neurooncología y otros cánceres
- Copyright:
-
- Copyright © 2019 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Cifras del artículo
Altmetric:
Citado por:
Autores
Contributions of authors
Link with Cochrane Review Group: CW Helm.
Drafted the protocol: CW Helm.
Searched for trials: OM Shariff, SM Grabosch, CW Helm.
Abstraction of study data: SM Grabosch, OMS Shariff, CW Helm.
Writing of the review: SM Grabosch, CW Helm.
Sources of support
Internal sources
-
None, Other.
External sources
-
None, Other.
Declarations of interest
None known.
Acknowledgements
We would like to acknowledge Judith Wulff for her help. We thank Aaron Howell, Administrative Assistant, Division of Gynecologic Oncology; James Graham, Brown Cancer Center, University of Louisville, USA for assistance with the first phase of this review; Jo Morrison for clinical and editorial advice; Jo Platt for designing and running the searches and Gail Quinn, Clare Jess and Tracey Harrison for their contribution to the editorial process.
This project was supported by the National Institute for Health Research, via Cochrane Infrastructure funding to the Cochrane Gynaecological, Neuro‐oncology and Orphan Cancer Group. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Systematic Reviews Programme, NIHR, NHS or the Department of Health.
Version history
| Published | Title | Stage | Authors | Version |
| 2018 Feb 12 | Non‐steroidal anti‐inflammatory agents to induce regression and prevent the progression of cervical intraepithelial neoplasia | Review | Shannon M Grabosch, Osman M Shariff, C. William Helm | |
| 2014 Apr 09 | Non‐steroidal anti‐inflammatory agents to induce regression and prevent the progression of cervical intraepithelial neoplasia | Review | Shannon M Grabosch, Osman M Shariff, Judith L Wulff, C. William Helm | |
| 2008 Apr 23 | Anti‐inflammatory agents for preventing the progression of cervical intraepithelial neoplasia | Protocol | Osman M Shariff, Judith L Wulff, C. William Helm | |
| 2003 Jan 20 | Anti‐inflammatory agents for preventing the progression of cervical intraepithelial neoplasia | Protocol | C W Helm, Nicholas J Meyer, William Helm | |
Differences between protocol and review
Shannon Grabosch MD joined the review group. The search strategy was reworked to make it more effective and an up‐to‐date search was performed. The background was extensively edited and updated. The manuscript was edited to reflect the search and literature information and the updated Cochrane review requirements and guidelines.
Keywords
MeSH
Medical Subject Headings (MeSH) Keywords
- Administration, Oral;
- Anti-Inflammatory Agents, Non-Steroidal [administration & dosage, *therapeutic use];
- Celecoxib [therapeutic use];
- Cyclooxygenase 2 Inhibitors [administration & dosage, *therapeutic use];
- Disease Progression;
- Induction Chemotherapy [*methods];
- Lactones [administration & dosage, therapeutic use];
- Placebos [therapeutic use];
- Randomized Controlled Trials as Topic;
- Sulfonamides [administration & dosage, therapeutic use];
- Sulfones [administration & dosage, therapeutic use];
- Uterine Cervical Dysplasia [*drug therapy, pathology];
- Uterine Cervical Neoplasms [*drug therapy, pathology];
Medical Subject Headings Check Words
Adult; Female; Humans;
PICO
Study flow diagram.
'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
Comparison 1 Progression of CIN, Outcome 1 Progression of CIN to higher grade of CIN.
Comparison 2 Regression of CIN 2 and 3, Outcome 1 Partial or complete regression of CIN 2 or CIN 3.
Comparison 2 Regression of CIN 2 and 3, Outcome 2 Complete regression of CIN 2 or CIN 3.
Comparison 2 Regression of CIN 2 and 3, Outcome 3 Partial regression of CIN 2 or CIN 3.
| Non‐steroidal anti‐inflammatory agents (NSAIDs) compared with placebo for CIN 2 or CIN 3 | ||||||
| Patient or population: women with CIN 2 or CIN 3 Settings: outpatient Intervention: celecoxib 400 mg by mouth daily for 14‐18 weeks, celecoxib 200 mg by mouth twice daily for six months or rofecoxib 40 mg by mouth daily for three months Comparison: placebo tablet by mouth, daily for three to six months | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | No. of Participants | Certainty of the evidence | Comments | |
| Assumed risk | Corresponding risk | |||||
| Progression of CIN to a higher grade of CIN | 77 per 10001 | 42 per 1000 | RR 0.54 (0.06 to 5.24) | 25 (one study) | ⊕⊝⊝⊝3 | |
| Partial or complete regression of CIN 2 or CIN 3 | 308 per 10002 | 447 per 1000 | RR 1.45 (0.93 to 2.27) | 132 (three studies) | ⊕⊕⊕⊝3 | |
| Complete regression of CIN 2 or CIN 3 | 174 per 10001 | 228 per 1000 | RR 1.31 (0.65 to 2.67) | 116 (two studies) | ⊕⊕⊕⊝3 | |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). | ||||||
| GRADE Working Group grades of evidence | ||||||
| 1The basis for the assumed risk is from the spontaneous complete regression rate in the placebo arm of Farley 2006 and Rader 2017 2 The basis for the assumed risk is from the combined spontaneous partial or complete regression rates in the placebo arms of Farley 2006; Hefler 2006; Rader 2017 3Given the increased sample size with the addition of Rader 2017, we have upgraded the certainty to high other than the Progression analysis as it is based on one small study and thus remained very low certainty. | ||||||
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Progression of CIN to higher grade of CIN Show forest plot | 1 | 25 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.54 [0.06, 5.24] |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Partial or complete regression of CIN 2 or CIN 3 Show forest plot | 3 | 132 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.45 [0.93, 2.27] |
| 2 Complete regression of CIN 2 or CIN 3 Show forest plot | 2 | 116 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.31 [0.65, 2.67] |
| 3 Partial regression of CIN 2 or CIN 3 Show forest plot | 2 | 116 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.56 [0.72, 3.40] |
