Table 7.4Global efficacy

Global efficacy outcomeReferenceInterventionAssessment timeOutcome/effect size
WOMAC total1 MA (Towheed et al. 2006), 3 RCTsNSAIDs (ibuprofen 2400 mg, diclofenac, arthrotec, celecoxib, naproxen) vs paracetamolMean duration 13.1 weeks (range 1–104 weeks)SMD −0.25, 95% CI−0.39 to −0.11, p<0.05
Favours NSAIDs
WOMAC total1 MA(Towheed et al. 2006) 1 RCTNSAIDs (ibuprofen 1200 mg, arthrotec, rofecoxib 25 mg, naproxen) vs paracetamolMean duration 13.1 weeks (range 1–104 weeks)SMD −0.46, 95% CI −0.73 to −0.19, p<0.05
Favours NSAIDs
Patient global assessment of overall efficacy1 MA(Towheed et al. 2006) 2 RCTsNSAIDs (ibuprofen 2400 mg, diclofenac, arthrotec, celecoxib, naproxen) vs paracetamolMean duration 13.1 weeks (range 1–104 weeks)NS
Patient global assessment of overall efficacy1 MA(Towheed et al. 2006) 2 RCTsNSAIDs (ibuprofen 2400 mg, diclofenac, arthrotec, celecoxib, naproxen) vs paracetamolMean duration 13.1 weeks (range 1–104 weeks)RR 1.23, 95% CI 1.06 to 1.43, p<0.05
Favours NSAIDs
Patient global assessment of overall efficacy1 MA(Towheed et al. 2006), 3 RCTsNSAIDs (ibuprofen 1200 mg, arthrotec, rofecoxib 25 mg, naproxen) vs paracetamolMean duration 13.1 weeks (range 1–104 weeks)RR 1.50, 95% CI 1.27 to 1.76, p<0.05
Favours NSAIDs
Patient global assessment of overall efficacy1 MA (Towheed et al. 2006), 3 RCTsNSAIDs (ibuprofen 1200 mg, arthrotec, rofecoxib 12.5 mg, naproxen) vs paracetamolMean duration 13.1 weeks (range 1–104 weeks)Significant heterogeneity
Physician global assessment of overall efficacy1 MA (Towheed et al. 2006)NSAIDs vs paracetamolMean duration 13.1 weeks (range 1–104 weeks)NS
Patient preference (for pain and stiffness)1 RCT (Nikles et al. 2005), N=116NSAIDs vs paracetamoln/a5% favoured NSAIDs, and 2% favoured paracetamol
Both groups similar
Patient preference (for general efficacy)1 N-of-1 trial (Wegman et al. 2003), N=13NSAIDs vs paracetamoln/a71% = no preference participants
29% = preferred NSAIDs

From: 7, Pharmacological management of osteoarthritis

Cover of Osteoarthritis
Osteoarthritis: National Clinical Guideline for Care and Management in Adults.
NICE Clinical Guidelines, No. 59.
National Collaborating Centre for Chronic Conditions (UK).
Copyright © 2008, Royal College of Physicians of London.

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