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Table 1 Use of non-steroidal anti-inflammatory drugs

From: Non-steroidal anti-inflammatory drugs for the treatment of pain and immobility-associated osteoarthritis: consensus guidance for primary care

Statement

Category of evidence

NSAIDs are effective drugs in relieving pain and immobility associated with osteoarthritis. COX-2 selective agents are equally effective.

A*

NSAIDs and COX-2 inhibitors vary in their potential gastrointestinal, liver and cardio-renal toxicity. This risk varies between individual treatments within both groups and is increased with dose and duration of treatment

A*

COX-2 selective agents are associated with a significantly lower gastrointestinal toxicity (PUBs and dyspepsia) compared to non-selective NSAIDs. Co-prescribing of aspirin reduces this advantage.

A*

PPI should always be considered with a non-selective NSAID and with a COX-2 agent in higher GI risk patients.

C†

  1. *A-Directly based on evidence from a meta-analysis of randomised controlled trials or from at least one randomised controlled trials
  2. †C Directly based on evidence from non-experimental descriptive studies, such as comparative studies, correlation studies and case control studies or extrapolated from meta-analysis of randomised controlled trials, or extrapolated from at least one randomised controlled trial.