PMID- 32256790
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 1792-0981 (Print)
IS  - 1792-1015 (Electronic)
IS  - 1792-0981 (Linking)
VI  - 19
IP  - 4
DP  - 2020 Apr
TI  - Indirect comparison of NSAIDs for ankylosing spondylitis: Network meta-analysis 
      of randomized, double-blinded, controlled trials.
PG  - 3031-3041
LID - 10.3892/etm.2020.8564 [doi]
AB  - Ankylosing spondylitis (AS) is a chronic inflammatory disease characterized by 
      lower back pain, enthesitis and asymmetrical peripheral arthritis. Non-steroidal 
      anti-inflammatory drugs (NSAIDs) are recommended as a first-line drug treatment 
      for AS. The aim of the present study was to evaluate the efficacy and safety of 
      NSAIDs in patients with active AS. A total of 9 randomized controlled trials 
      focusing on 6 NSAIDs, including etoricoxib, celecoxib, meloxicam, diclofenac, 
      naproxen and beta-D-mannuronic acid (M2000), were analyzed in the present study. 
      The efficacy endpoints included total pain score, patients' global assessment of 
      disease activity (PGA), Bath Ankylosing Spondylitis Functional Index (BASFI) and 
      the rate of achieving an Assessment in Ankylosing Spondylitis 20% response 
      (ASAS20). The safety endpoints included total adverse events (AEs), 
      gastrointestinal (GI) AEs, withdrawals due to AEs and serious AEs. NSAIDs were 
      compared with the placebo and among themselves using Bayesian network 
      meta-analysis, calculating mean differences (MDs) for continuous data and odds 
      ratios for dichotomous data. The analysis revealed that all NSAIDs were 
      significantly more effective in reducing pain severity than placebo (MDs between 
      -17.49 and -25.99). Similarly, significant improvements in PGA, BASFI and ASAS20 
      were determined in patients receiving NSAIDs. Furthermore, etoricoxib was ranked 
      as the most efficacious treatment for patients with AS. With regard to safety, 
      there were no significant differences between NSAIDs and placebo in terms of 
      total AEs, withdrawals due to AEs or serious AEs. Furthermore, no significant 
      differences in AEs were identified between M2000 and the placebo. However, 
      patients treated with diclofenac and naproxen had a higher risk of GI events than 
      those taking placebo. In conclusion, the NSAIDs were all highly effective and 
      well-tolerated in the treatment of AS. However, clinicians should take GI 
      toxicity into account when prescribing NSAIDs.
CI  - Copyright: (c) Fan et al.
FAU - Fan, Meida
AU  - Fan M
AD  - Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen 
      University, Guangzhou, Guangdong 510630, P.R. China.
AD  - Department of Rheumatology, Nanfang Hospital, Southern Medical University, 
      Guangzhou, Guangdong 510515, P.R. China.
FAU - Liu, Jian
AU  - Liu J
AD  - Department of Anesthesiology, Nanfang Hospital, Southern Medical University, 
      Guangzhou, Guangdong 510515, P.R. China.
FAU - Zhao, Bingcheng
AU  - Zhao B
AD  - Department of Anesthesiology, Nanfang Hospital, Southern Medical University, 
      Guangzhou, Guangdong 510515, P.R. China.
FAU - Wu, Xinyu
AU  - Wu X
AD  - Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen 
      University, Guangzhou, Guangdong 510630, P.R. China.
FAU - Li, Xuefeng
AU  - Li X
AD  - Department of Gastrointestinal Surgery, The Sixth Affiliated Hospital of 
      Guangzhou Medical University, Qingyuan People's Hospital, State Key Laboratory of 
      Respiratory Disease, Sino-French Hoffmann Institute, School of Basic Medical 
      Sciences, Guangzhou Medical University, Guangzhou, Guangdong 511436, P.R. China.
AD  - Shenzhen Following Precision Medical Research Institute, Shenzhen Luohu People's 
      Hospital, The Third Affiliated Hospital of Shenzhen University, Shenzhen, 
      Guangdong 518001, P.R. China.
AD  - Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of 
      Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology 
      and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, 
      Chinese Academy of Sciences, Guangzhou, Guangdong 510530, P.R. China.
FAU - Gu, Jieruo
AU  - Gu J
AD  - Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen 
      University, Guangzhou, Guangdong 510630, P.R. China.
LA  - eng
PT  - Journal Article
DEP - 20200227
PL  - Greece
TA  - Exp Ther Med
JT  - Experimental and therapeutic medicine
JID - 101531947
PMC - PMC7086213
OTO - NOTNLM
OT  - ankylosing spondylitis
OT  - efficacy
OT  - meta-analysis
OT  - non-steroidal anti-inflammatory drugs
OT  - safety
EDAT- 2020/04/08 06:00
MHDA- 2020/04/08 06:01
PMCR- 2020/02/27
CRDT- 2020/04/08 06:00
PHST- 2019/04/03 00:00 [received]
PHST- 2019/11/15 00:00 [accepted]
PHST- 2020/04/08 06:00 [entrez]
PHST- 2020/04/08 06:00 [pubmed]
PHST- 2020/04/08 06:01 [medline]
PHST- 2020/02/27 00:00 [pmc-release]
AID - ETM-0-0-8564 [pii]
AID - 10.3892/etm.2020.8564 [doi]
PST - ppublish
SO  - Exp Ther Med. 2020 Apr;19(4):3031-3041. doi: 10.3892/etm.2020.8564. Epub 2020 Feb 
      27.