Cochrane · systematic review · CD010120
Non‐steroidal anti‐inflammatory drugs for acute gout
van Durme, CMPG, Wechalekar, MD, Landewé, RBM, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
20
No studies
1
Included studies
NR
No studies 1 · 4.8%Ungraded 0 · 0%Very low 0 · 0%Low 10 · 47.6%Moderate 10 · 47.6%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyNSAIDs compared to placebo for acute gout
Population: acute gout
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain: ≥ 50% improvement in pain (spontaneous pain at 24 hours) NSAIDs vs placebo | RR 2.75 [1.13, 6.72] | NR | Low Downgraded: risk of bias |
Inflammation: swelling NSAIDs vs placebo | RR 1.08 [0.79, 1.49] | NR | Low Downgraded: risk of bias |
Function: ≥ 50% improvement in pain with movement at 24 hours NSAIDs vs placebo | RR 4 [0.5, 31.74] | NR | Low Downgraded: risk of bias |
Participants' global assessment of treatment: not measured№. of participants: 30 (1 RCT) NSAIDs vs placebo | no estimate extracted | NR | Low Downgraded: risk of bias |
Health‐related quality of life: not measured№. of participants: 30 (1 RCT) NSAIDs vs placebo | no estimate extracted | NR | Low Downgraded: risk of bias |
Withdrawals due to adverse events NSAIDs vs placebo | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision |
Total adverse events NSAIDs vs placebo | RR 0.2 [0.01, 3.85] | NR | Low Downgraded: risk of bias |
Non‐selective NSAIDs versus selective cyclo‐oxygenase‐2 inhibitors
Population: acute gout
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain: mean change from baseline on 5‐point (0 to 4, 0 no pain) Likert scale Non‐selective NSAIDs vs selective cyclo‐oxygenase‐2 inhibitors | no estimate extracted | NR | Moderate Downgraded: risk of bias |
Inflammation (swelling): mean change from baselineon 4‐point (0 to 3, 0 no swelling) Likert scale Non‐selective NSAIDs vs selective cyclo‐oxygenase‐2 inhibitors | no estimate extracted | NR | Moderate Downgraded: risk of bias |
Function: mean change in pain with movement from baseline on4‐point (0 to 3, 0 best function) Likert scale Non‐selective NSAIDs vs selective cyclo‐oxygenase‐2 inhibitors | no estimate extracted | NR | Low Downgraded: risk of bias |
Participants' global assessment of treatment successon 5‐point (0 very good) Likert scale Non‐selective NSAIDs vs selective cyclo‐oxygenase‐2 inhibitors | no estimate extracted | NR | Moderate Downgraded: risk of bias |
Health‐related quality of life on SF‐36 (mental health component)Scale from 0 to 100 (0 worst quality of life) Non‐selective NSAIDs vs selective cyclo‐oxygenase‐2 inhibitors | no estimate extracted | NR | Low Downgraded: risk of bias |
Withdrawals due to adverse events Non‐selective NSAIDs vs selective cyclo‐oxygenase‐2 inhibitors | RR 2.34 [1.33, 4.14] | NR | Moderate Downgraded: risk of bias |
Total adverse events Non‐selective NSAIDs vs selective cyclo‐oxygenase‐2 inhibitors | RR 1.94 [1.36, 2.78] | NR | Moderate Downgraded: risk of bias |
NSAIDs compared to glucocorticoids for acute gout
Population: acute gout
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain: mean decrease per hour on a VAS scale (0 to 100, 0 no pain) NSAIDs vs glucocorticoids | no estimate extracted | NR | Moderate Downgraded: risk of bias |
Inflammation: swelling mean difference in change from baseline to 14 days NSAIDs vs glucocorticoids | no estimate extracted | NR | Low Downgraded: risk of bias |
Function: walking disability during first 6 hours NSAIDs vs glucocorticoids | no estimate extracted | NR | Moderate Downgraded: risk of bias |
Patients' global assessment of treatment success at day 3 to 4 NSAIDs vs glucocorticoids | RR 0.92 [0.7, 1.22] | NR | Moderate Downgraded: risk of bias |
Health‐related quality of life (HRQoL)Not reported NSAIDs vs glucocorticoids | no estimate extracted | NR | No studies |
Withdrawals due to adverse events NSAIDs vs glucocorticoids | RR 2.8 [0.55, 14.22] | NR | Moderate Downgraded: risk of bias |
Total adverse events NSAIDs vs glucocorticoids | RR 1.62 [1.03, 2.55] | NR | Moderate Downgraded: risk of bias |
NSAIDs compared with placebo for acute gout
Population: acute gout
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain improvement by 50% Proportion with ≥ 50% reduction 1 NSAIDs vs placebo | RR 2.75 [1.13, 6.72] | 1 study · 30 participants | Low Downgraded: risk of bias, imprecision |
Inflammation ‐ joint swelling improvement Proportion with ≥ 50% improvement NSAIDs vs placebo | RR 1.08 [0.79, 1.49] | 1 study · 30 participants | Low Downgraded: risk of bias, imprecision |
Joint function ‐ not measured NSAIDs vs placebo | no estimate extracted | NR | No studies |
Participant global assessment of treatment ‐ not measured NSAIDs vs placebo | no estimate extracted | NR | No studies |
Health‐related quality of life ‐ not measured NSAIDs vs placebo | no estimate extracted | NR | No studies |
Withdrawals due to adverse events ‐ not reported NSAIDs vs placebo | no estimate extracted | NR | No studies |
Adverse events participant's reporting NSAIDs vs placebo | RR 0.2 [0.01, 3.85] | 1 study · 30 participants | Low Downgraded: risk of bias, imprecision |
NSAIDs compared with COXIBs for acute gout
Population: people with acute gout
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain: mean pain reduction from baseline Scale from: 0 to 10, lower score better NSAIDs vs COXIBs | no estimate extracted | 4 studies · 746 participants | Moderate Downgraded: risk of bias |
Inflammation: swelling Likert Scale from 0 to 3 (0 was best score) NSAIDs vs COXIBs | no estimate extracted | 4 studies · 735 participants | Moderate Downgraded: risk of bias |
Function Not measured NSAIDs vs COXIBs | no estimate extracted | NR | No studies |
Global Assessment of treatment success Participant‐reported Likert Scale from 0 to 4 (0 best score) NSAIDs vs COXIBs | no estimate extracted | 3 studies · 555 participants | Moderate Downgraded: risk of bias |
Health‐related quality of life ‐ Physical Health component SF‐36 questionnaire (scale 0‐100, 0 was worst) NSAIDs vs COXIBs | no estimate extracted | 1 study · 222 participants | Moderate Downgraded: risk of bias |
Safety ‐ withdrawals due to adverse events Participant reported NSAIDs vs COXIBs | RR 2.4 [1.35, 4.27] | 4 studies · 974 participants | Moderate Downgraded: risk of bias |
Safety ‐ total adverse events Participant reported NSAIDs vs COXIBs | RR 1.58 [1.38, 1.81] | 4 studies · 974 participants | Moderate Downgraded: risk of bias |
NSAIDS compared with glucocorticoids for acute gout
Population: people with acute gout
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain: mean reduction over VAS per 1‐6 hours VAS, ranging from 0 to 100 (0 was no pain) NSAIDS vs glucocorticoids | no estimate extracted | 2 studies · 208 participants | Moderate |
Inflammation Not measured NSAIDS vs glucocorticoids | no estimate extracted | NR | No studies |
Function: walking disability VAS ranging from 1 to 100 (0 was no disability) NSAIDS vs glucocorticoids | no estimate extracted | 1 study · 118 participants | Low Downgraded: risk of bias |
Participant's Global Assessment of treatment Not measured NSAIDS vs glucocorticoids | no estimate extracted | NR | No studies |
Health‐related Quality of Life Not measured NSAIDS vs glucocorticoids | no estimate extracted | NR | No studies |
Safety ‐ withdrawals due to adverse events NSAIDS vs glucocorticoids | no estimate extracted | NR | No studies |
Safety ‐ total adverse events Participant reported NSAIDS vs glucocorticoids | RR 1.58 [0.76, 3.28] | 2 studies · 208 participants | Moderate Downgraded: risk of bias |