Meloxicam compared with naproxen for chronic non‐cancer pain

Patient or population: children and adolescents with chronic non‐cancer pain

Settings: multicentre paediatric rheumatology tertiary care units (international)

Intervention: meloxicam

Comparison: naproxen

Participant‐reported pain relief of 30% or greater

N/A

225 participants

(1 study)

⊕⊕⊝⊝
low^a

Participant‐reported pain relief of 50% or greater

N/A

225 participants

(1 study)

⊕⊕⊝⊝
low^a

Patient Global Impression of Change much or very much improved

N/A

N/A

No evidence to support or refute^c

Any adverse event

N/A

225 participants

(1 study)

⊕⊝⊝⊝
very low^b

Serious adverse event

N/A

225 participants

(1 study)

⊕⊝⊝⊝
very low^b

Withdrawals due to adverse events

N/A

225 participants

(1 study)

⊕⊝⊝⊝
very low^b

*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).

CI: confidence interval; N/A: not applicable

GRADE Working Group grades of evidence

High quality: We are very confident that the true effect lies close to that of the estimate of the effect.

Moderate quality: We are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of effect, but there is a possibility that it is substantially different.

Low quality: Our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect.

Very low quality: We have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect.

Celecoxib compared with naproxen for chronic non‐cancer pain

Patient or population: children and adolescents with chronic non‐cancer pain

Settings: 17 paediatric centres worldwide

Intervention: celecoxib

Comparison: naproxen

Participant‐reported pain relief of 30% or greater

N/A

242 participants
(1 study)

⊕⊕⊝⊝
low^a

Participant‐reported pain relief of 50% or greater

N/A

N/A

‐

No evidence to support or refute^c

Patient Global Impression of Change much or very much improved

N/A

N/A

‐

No evidence to support or refute^c

Any adverse event

N/A

N/A

‐

No evidence to support or refute^c

Serious adverse event

N/A

242 participants
(1 study)

⊕⊝⊝⊝
very low^b

Withdrawals due to adverse events

N/A

242 participants
(1 study)

⊕⊝⊝⊝
very low^b

*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).
CI: confidence interval; N/A: not applicable

GRADE Working Group grades of evidence

High quality: We are very confident that the true effect lies close to that of the estimate of the effect.

Moderate quality: We are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of effect, but there is a possibility that it is substantially different.

Low quality: Our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect.

Very low quality: We have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect.

Rofecoxib compared with naproxen for chronic non‐cancer pain

Patient or population: children and adolescents with chronic non‐cancer pain

Settings: 41 clinical centres in Australia, Europe, Asia, Central America, South America, USA

Intervention: rofecoxib

Comparison: naproxen

Participant‐reported pain relief of 30% or greater

N/A

274 participants
(1 study)

⊕⊕⊝⊝
low^a

Participant‐reported pain relief of 50% or greater

N/A

N/A

‐

No evidence to support or refute^c

Patient Global Impression of Change much or very much improved

N/A

N/A

‐

No evidence to support or refute^c

Any adverse event

N/A

274 participants
(1 study)

⊕⊝⊝⊝
very low^b

Serious adverse event

N/A

310 participants
(1 study)

⊕⊝⊝⊝
very low^b

Withdrawals due to adverse events

N/A

310 participants
(1 study)

⊕⊝⊝⊝
very low^b

*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).
CI: confidence interval; N/A: not applicable

GRADE Working Group grades of evidence

High quality: We are very confident that the true effect lies close to that of the estimate of the effect.

Moderate quality: We are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of effect, but there is a possibility that it is substantially different.

Low quality: Our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect.

Very low quality: We have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect.