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Cited by 454

The DOI matches its Crossref record; 45 of the 45 references it cites were found in a registry or an index.

Non-steroidal anti-inflammatory drugs, including cyclo-oxygenase-2 inhibitors, in osteoarthritic knee pain: meta-analysis of randomised placebo controlled trials

Open access
Bjordal, Jan Magnus, Ljunggren, Anne Elisabeth, Klovning, Atle, Slørdal, Lars·2004·BMJ

Abstract

OBJECTIVE: To estimate the analgesic efficacy of non-steroidal anti-inflammatory drugs (NSAIDs), including selective cyclo-oxygenase-2 inhibitors (coxibs), in patients with osteoarthritis of the knee. DESIGN: Systematic review and meta-analysis of randomised placebo controlled trials. STUDIES REVIEWED: 23 trials including 10 845 patients, median age of 62.5 years. 7807 patients received adequate doses of NSAIDs and 3038 received placebo. The mean weighted baseline pain score was 64.2 mm on 100 mm visual analogue scale (VAS), and average duration of symptoms was 8.2 years. MAIN OUTCOME MEASURE: Change in overall intensity of pain. RESULTS: Methodological quality of trials was acceptable, but 13 trials excluded patients before randomisation if they did not respond to NSAIDs. One trial provided long term data for pain that showed no significant effect of NSAIDs compared with placebo at one to four years. The pooled difference for pain on visual analogue scale in all included trials was 10.1 mm (95% confidence interval 7.4 to 12.8) or 15.6% better than placebo after 2-13 weeks. The results were heterogeneous, and the effect size for pain reduction was 0.32 (0.24 to 0.39) in a random effects model. In 10 trials that did not exclude non-responders to NSAID treatment the results were homogeneous, with an effect size for pain reduction of 0.23 (0.15 to 0.31). CONCLUSION: NSAIDs can reduce short term pain in osteoarthritis of the knee slightly better than placebo, but the current analysis does not support long term use of NSAIDs for this condition. As serious adverse effects are associated with oral NSAIDs, only limited use can be recommended.

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Metadata

Authors
Bjordal, J. M., Ljunggren, A. E., Klovning, A., & Slørdal, L.
Venue
BMJ
Publisher
BMJ
Published
2004-11-23
Volume
329
Issue
7478
Pages
1317
ISSN
  • 0007-1447 (ISSN-L)
  • 0959-8138
  • 1468-5833
OpenAlex
W2106903173
Cited by
454
References
45
FWCI
3.51
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Non-steroidal anti-inflammatory drugs, including cyclo-oxygenase-2 inhibitors, in osteoarthritic knee pain: meta-analysis of randomised placebo controlled trials. https://app.cochat.ai/papers/10.1136/bmj.38273.626655.63
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Bjordal, J. M., Ljunggren, A. E., Klovning, A., & Slørdal, L. (2004). Non-steroidal anti-inflammatory drugs, including cyclo-oxygenase-2 inhibitors, in osteoarthritic knee pain: meta-analysis of randomised placebo controlled trials. BMJ. https://doi.org/10.1136/bmj.38273.626655.63

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