Evidence map›Paper›PMID 32276272›Full record

SynthesisRheumatology (Oxford, England)2020

Predicting response to topical non-steroidal anti-inflammatory drugs in osteoarthritis: an individual patient data meta-analysis of randomized controlled trials.

Monica S M Persson, Joanne Stocks, Gyula Varadi, Mohammad Hashem Hashempur, Marienke van Middelkoop, Sita Bierma-Zeinstra, David A Walsh, Michael Doherty, Weiya Zhang

Abstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Rheumatology (Oxford, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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  12. Pharmaceutical biology · 2022
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  20. The Efficacy ofEvidence-based complementary and alternative medicine : eCAM · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Monica S M PerssonAcademic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK.
Joanne StocksAcademic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK.
Gyula VaradiBioPhysics Pharma, Beverly, MA, USA.
Mohammad Hashem HashempurDepartment of Traditional Persian Medicine, Fasa University of Medical Sciences, Fasa, Iran.
Marienke van MiddelkoopDepartment of General Practice, University Medical Center, Erasmus Medical Center, Rotterdam, The Netherlands.
Sita Bierma-ZeinstraDepartment of General Practice, University Medical Center, Erasmus Medical Center, Rotterdam, The Netherlands.
David A WalshAcademic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK.
Michael DohertyAcademic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK.
Weiya ZhangAcademic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo identify predictors of the specific (difference between treatment and placebo) and overall (change from baseline in treatment arm) treatment effects of topical NSAIDs in OA.

methodsRandomized controlled trials (RCTs) of topical NSAIDs in OA were identified through systematic literature searching and inquiry to pharmaceutical companies. The raw, de-identified data were analysed in one-stage individual patient data meta-analysis (IPD-MA). Negative values for treatment effects (0-100 scale) indicate pain reduction.

resultsOf 63 eligible RCTs, 15 provided IPD (n = 1951 on topical NSAID), including 11 placebo-controlled RCTs (n = 1587 on topical NSAIDs, 1553 on placebo). Seven potential predictors of response were examined. Topical NSAIDs were superior to placebo [-6 (95% CI -9, -4)], with a small, but statistically significant greater effect in women than men [difference -4 (95% CI -8, -1)]. The overall treatment effect was 4-fold larger than the specific effect [-25 (95% CI -31, -19)] and increased with greater baseline pain severity (P < 0.001). No differences in efficacy were observed for age, BMI, features of inflammation, duration of complaints or radiographic OA severity.

conclusionTopical NSAIDs are effective for OA pain relief. Greater overall pain relief in individuals with more baseline pain might be due to contextual and non-specific effects, including regression to the mean. Additional factors that have been linked either mechanistically or through empirical evidence to outcomes should be selected for inclusion across future RCTs in order to facilitate the identification of response predictors through IPD-MA.

Indexed as

Administration, TopicalAdultAgedAnti-Inflammatory Agents, Non-SteroidalFemaleHumansMaleMiddle AgedOsteoarthritisPain ManagementRandomized Controlled Trials as TopicTreatment OutcomeAnti-Inflammatory Agents, Non-SteroidalIPD meta-analysisosteoarthritispredictorstopical NSAIDs

Identifiers

PMID32276272
PMCPMC7449808

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.