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Celecoxib para la artrosis
Livia Puljak, Ana Marin, Davorka Vrdoljak, Filipa Markotic, Ana Utrobicic, Peter Tugwell | 22 mayo 2017

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Temas

Comparison 2 Sulphur baths versus Dead Sea baths, Outcome 1 Function.
Figuras y tablas -
Analysis 2.1

Comparison 2 Sulphur baths versus Dead Sea baths, Outcome 1 Function.

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Comparison 2 Sulphur baths versus Dead Sea baths, Outcome 2 Pain (10 cm VAS).
Figuras y tablas -
Analysis 2.2

Comparison 2 Sulphur baths versus Dead Sea baths, Outcome 2 Pain (10 cm VAS).

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Comparison 3 Tapwater baths additional on exercises, Outcome 1 Stiffness.
Figuras y tablas -
Analysis 3.1

Comparison 3 Tapwater baths additional on exercises, Outcome 1 Stiffness.

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Comparison 5 Sulphur baths versus no treatment, Outcome 1 Pain (10 cm VAS).
Figuras y tablas -
Analysis 5.1

Comparison 5 Sulphur baths versus no treatment, Outcome 1 Pain (10 cm VAS).

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Comparison 5 Sulphur baths versus no treatment, Outcome 2 Function.
Figuras y tablas -
Analysis 5.2

Comparison 5 Sulphur baths versus no treatment, Outcome 2 Function.

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Comparison 6 Dead Sea baths versus no treatment, Outcome 1 Pain (10 cm VAS).
Figuras y tablas -
Analysis 6.1

Comparison 6 Dead Sea baths versus no treatment, Outcome 1 Pain (10 cm VAS).

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Comparison 6 Dead Sea baths versus no treatment, Outcome 2 Function.
Figuras y tablas -
Analysis 6.2

Comparison 6 Dead Sea baths versus no treatment, Outcome 2 Function.

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Comparison 7 Sulphur + Dead Sea baths versus no treatment, Outcome 1 Pain (10 cm VAS).
Figuras y tablas -
Analysis 7.1

Comparison 7 Sulphur + Dead Sea baths versus no treatment, Outcome 1 Pain (10 cm VAS).

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Comparison 7 Sulphur + Dead Sea baths versus no treatment, Outcome 2 Function.
Figuras y tablas -
Analysis 7.2

Comparison 7 Sulphur + Dead Sea baths versus no treatment, Outcome 2 Function.

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Comparison 8 Mineral baths versus no treatment, Outcome 1 Pain (100 mm VAS).
Figuras y tablas -
Analysis 8.1

Comparison 8 Mineral baths versus no treatment, Outcome 1 Pain (100 mm VAS).

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Comparison 8 Mineral baths versus no treatment, Outcome 2 Quality of life.
Figuras y tablas -
Analysis 8.2

Comparison 8 Mineral baths versus no treatment, Outcome 2 Quality of life.

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Comparison 8 Mineral baths versus no treatment, Outcome 3 Analgesic intake.
Figuras y tablas -
Analysis 8.3

Comparison 8 Mineral baths versus no treatment, Outcome 3 Analgesic intake.

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Comparison 8 Mineral baths versus no treatment, Outcome 4 Analgesic intake.
Figuras y tablas -
Analysis 8.4

Comparison 8 Mineral baths versus no treatment, Outcome 4 Analgesic intake.

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Table 1. Methodological quality

Study

Randomisation

Concealment

Baseline comparison

Eligibility criteria

Blinded outcome ass

Blinded careprovider

Blinded patient

Data presentation

Intention to treat

Allard '98

Yes

Unclear

Unclear

No

Unclear

No

No

No

No

Green '93

Yes

Unclear

Unclear

Yes

Yes

Unclear

Unclear

No

No

Kovács '02

Yes

Unclear

Unclear

No

Yes

Unclear

Yes

Yes

No

Nguyen '97

Yes

Unclear

Yes

Yes

No

No

No

Yes

No

Sukenik '99

Yes

Unclear

Unclear

Yes

Yes

No

No

Yes

No

Tishler '04

Yes

Unclear

Yes

Yes

Unclear

No

No

Yes

No

Wigler '95

Yes

Unclear

Yes

Yes

Yes

Unclear

Yes

No

Yes
Figuras y tablas -
Table 1. Methodological quality
Ir a la tabla de la revisión
Table 2. Clinical relevance table: pain at follow‐up

Study

Treatment group

Outcome

N

Baseline mean

End of study mean

Abs benefit

Rel difference

Stat significance

Quality of evidence

Kovacs '02

E: Mineral baths

Pain (10 cm VAS)

31

diff: ‐0.29 (SD 1.22)

0.006 (0.0006%)

Not sign

C: Placebo baths

27

diff: ‐0.296 (SD 0.78)

Nguyen '97

E: Mineral baths

Pain (100 mm VAS)

91

50 (SD 20)

41 (SD 28)

9 (0.09%)

18.5 %; NNT=5

Sign

Silver

C: Usual care

97

47 (SD 22)

50 (SD 24)

Sukenik '99

E: Sulphur baths

Pain (0‐10)

10

6.1 (SD 1.6)

6.2 (SD 1.5)

0.4 (0.004%)

6.6%

Not sign

C: Control

9

6.1 (1.5)

6.6 (SD 1.5)

Sukenik '99

E: Dead Sea baths

Pain (0‐10)

10

6.5 (SD 1.0)

6.1 (SD 1.0)

0.9 (0.009%)

14.8%

Not sign

C: Control

9

6.1 (SD 1.5)

6.6 (SD 1.5)

Sukenik '99

E: Sulphur + Dead Sea baths

Pain (0‐10)

7

6.6 (SD 1.0)

5.7 (SD 1.7)

1.4 (0.014%)

23.0%

Not sign

C: Control

9

6.1 (SD 1.5)

6.6 (SD 1.5)

Tishler '04

E: Mineral baths

Pain (100 mm VAS)

48

64.8 (SD 22.3)

26.3 (SD 22.3)

37.6 (0.376%)

56.6 %; NNT=2

Sign

Silver

C: No treatment

24

68.1 (SD 23.3)

63.9 (SD 23.3)

Legend:

0‐10 scale, 0 = no pain and 10 = severe pain
Sign = significant
Abs = absolute
Rel = relative
N = # of patients
NNT=number needed to treat (for an improvement of 15%)

Figuras y tablas -
Table 2. Clinical relevance table: pain at follow‐up
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Comparison 2. Sulphur baths versus Dead Sea baths

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Function Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

1.1 End of treatment

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 1 month follow‐up

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 3 month follow‐up

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2 Pain (10 cm VAS) Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

2.1 End of treatment

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 1 month follow‐up

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.3 3 month follow‐up

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]
Figuras y tablas -
Comparison 2. Sulphur baths versus Dead Sea baths
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Comparison 3. Tapwater baths additional on exercises

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Stiffness Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 3. Tapwater baths additional on exercises
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Comparison 5. Sulphur baths versus no treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Pain (10 cm VAS) Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

1.1 End of treatment

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 1 month follow‐up

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 3 month follow‐up

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2 Function Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

2.1 End of treatment

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 1 month follow‐up

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.3 3 month follow‐up

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]
Figuras y tablas -
Comparison 5. Sulphur baths versus no treatment
Ir a la tabla de la revisión
Comparison 6. Dead Sea baths versus no treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Pain (10 cm VAS) Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

1.1 End of treatment

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 1 month follow‐up

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 3 month follow‐up

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2 Function Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

2.1 End of treatment

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 1 month follow‐up

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.3 3 month follow‐up

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]
Figuras y tablas -
Comparison 6. Dead Sea baths versus no treatment
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Comparison 7. Sulphur + Dead Sea baths versus no treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Pain (10 cm VAS) Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

1.1 End of treatment

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 1 month follow‐up

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 3 month follow‐up

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2 Function Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

2.1 End of treatment

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 1 month follow‐up

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.3 3 month follow‐up

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]
Figuras y tablas -
Comparison 7. Sulphur + Dead Sea baths versus no treatment
Ir a la tabla de la revisión
Comparison 8. Mineral baths versus no treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Pain (100 mm VAS) Show forest plot

2

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

1.1 End of treatment

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 1 month follow‐up

2

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 6 month follow‐up

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2 Quality of life Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

2.1 1 month follow‐up

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 6 month follow‐up

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3 Analgesic intake Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

3.1 End of treatment

0

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.2 1 month follow‐up

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.3 6 month follow‐up

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4 Analgesic intake Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 8. Mineral baths versus no treatment
Ir a la tabla de la revisión