SynthesisAnnals of the rheumatic diseases2004
Time dependent risk of gastrointestinal complications induced by non-steroidal anti-inflammatory drug use: a consensus statement using a meta-analytic approach.
Synthesis in Annals of the rheumatic diseases, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00615875 (Naproxen for Acute Pain After Surgery), which is not on this map. Cited by 54 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Naproxen for Acute Pain After Surgery: A Randomized, Placebo-Controlled Trial
Who cites it
54 citing papers in PubMed, 3 syntheses or guidelines pooled it, 234 citations in OpenAlex.
- Platelet-rich plasma injections for hip osteoarthritis: a review of the evidence.Irish journal of medical science · 2021Pooled it
- Duration of Symptom Relief and Early Trajectory of Adverse Events for Oral Nonsteroidal Antiinflammatory Drugs in Knee Osteoarthritis: A Systematic Review and Meta-Analysis.Arthritis care & research · 2020Pooled it
- Safety of the nonselective NSAID nabumetone : focus on gastrointestinal tolerability.Drug safety · 2008Pooled it
- Assessing adverse effects of intra-articular botulinum toxin A in healthy Beagle dogs: A placebo-controlled, blinded, randomized trial.PloS one · 2018Trial
- Low-dose rectal diclofenac for prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis: a randomized controlled trial.Journal of gastroenterology · 2012Trial
- Long-term tolerability of topical diclofenac sodium 1% gel for osteoarthritis in seniors and patients with comorbidities.Clinical interventions in aging · 2012Trial
- Integration of gold standard arthroscopy, MRI and synovial histopathology outcomes for enhancing early knee osteoarthritis diagnosis.Aging clinical and experimental research · 2026Article
- Nonsteroidal Anti-Inflammatory Drug-Induced Peptic Ulcer Disease.The Korean journal of helicobacter and upper gastrointestinal research · 2025Review
- Analgesic Activity of 5-Acetamido-2-Hydroxy Benzoic Acid Derivatives and an In-Vivo and In-Silico Analysis of Their Target Interactions.Pharmaceuticals (Basel, Switzerland) · 2023Article
- Non-steroidal anti-inflammatory drugs in the perioperative period.BJA education · 2023Review
- The safety of botulinum neurotoxin type A's intraarticular application in experimental animals.Toxicon: X · 2023Article
- Metal Complexes with Naphthalene-Based Acetic Acids as Ligands: Structure and Biological Activity.Molecules (Basel, Switzerland) · 2023Review
- Pharmacological and Non-Pharmacological Methods of Postoperative Pain Control Following Oral and Maxillofacial Surgery: A Systematic Review.World journal of plastic surgery · 2023Review
- Microbiota-assisted therapy for systemic inflammatory arthritis: advances and mechanistic insights.Cellular and molecular life sciences : CMLS · 2022Review
- In Vitro Evaluation of Smart and pH-Sensitive Chondroitin Sulfate/Sodium Polystyrene Sulfonate Hydrogels for Controlled Drug Delivery.Gels (Basel, Switzerland) · 2022Article
- Multimorbidity patterns and associated factors in older Chinese: results from the China health and retirement longitudinal study.BMC geriatrics · 2022Article
- Rectal indomethacin and diclofenac are equally efficient in preventing pancreatitis following endoscopic retrograde cholangiopancreatography in average-risk patients.JGH open : an open access journal of gastroenterology and hepatology · 2021Review
- Fabrication and In Vitro Evaluation of pH-Sensitive Polymeric Hydrogels as Controlled Release Carriers.Gels (Basel, Switzerland) · 2021Article
- Prevention of Non-steroidal Anti-inflammatory Drug-induced Peptic Ulcers.The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2020Review
- A Comprehensive Review of Over-the-counter Treatment for Chronic Migraine Headaches.Current pain and headache reports · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo provide an updated document assessing the global, NSAID-specific, and time dependent risk of gastrointestinal (GI) complications through meta-analyses of high quality studies.
methodsAn exhaustive systematic search was performed. Inclusion criteria were: RCT or controlled study, duration of 5 days at least, inactive control, assessment of minor or major NSAID adverse effects, publication range January 1985 to January 2003. The publications retrieved were assessed during a specifically dedicated WHO meeting including leading experts in all related fields. Statistics were performed conservatively. Meta-regression was performed by regressing NSAID adjusted estimates against study duration categories.
resultsAmong RCT data, indolic derivates provided a significantly higher risk of GI complications related to NSAID use than for non-users: RR = 2.25 (1.00; 5.08) than did other compounds: naproxen: RR = 1.83 (1.25; 2.68); diclofenac: RR = 1.73 (1.21; 2.46); piroxicam: RR = 1.66 (1.14; 2.44); tenoxicam: RR = 1.43 (0.40; 5.14); meloxicam: RR = 1.24 (0.98; 1.56), and ibuprofen: RR = 1.19 (0.93; 1.54). Indometacin users had a maximum relative risk for complication at 14 days. The other compounds presented a better profile, with a maximum risk at 50 days. Significant additional risk factors included age, dose, and underlying disease. The controlled cohort studies provided higher estimates: RR = 2.22 (1.7; 2.9). Publication bias testing was significant, towards a selective publication of deleterious effects of NSAIDs from small sized studies.
conclusionThis meta-analysis characterised the "compound" and "time" aspects of the GI toxicity of non-selective NSAIDs. The risk/benefit ratio of such compounds should thus be carefully and individually evaluated at the start of long term treatment.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.