Review
Medicine, General & Internal
Chen Shi, Zhaoming Ye, Zengwu Shao, Bifa Fan, Cibo Huang, Yuan Zhang, Xinying Kuang, Liyan Miao, Xin'an Wu, Rongsheng Zhao, Xiao Chen, Bikui Zhang, Rongsheng Tong, Xin Hu, Zhijian Fu, Jianhao Lin, Xiaomei Li, Tiezheng Sun, Guoqiang Liu, Haibin Dai, Cheng Guo, Bo Zhang, Ting Xu, Aidong Wen, Xiaocong Zuo, Jinmei Liu, Xu Chen, Huibo Li, Jing Wang, Min Luo, Tingting Fan, Yulan Qian, Xiu'mao Li, Wenjie Qiu, Xiaowen Lin, Yingchang Pang, Yunfei Hou, Difei Yao, Wen Kou, Bao Sun, Can Hu, Yanzhe Xia, Ming Zhao, Changyu Zhu, Qian Li, Yu Zhang
Summary: The Chinese Pharmaceutical Association Hospital Pharmacy Professional Committee developed multidisciplinary guidelines on using topical NSAIDs to treat musculoskeletal pain. The guidelines include 11 recommendations and nine expert consensuses and are aimed at facilitating the rational use of topical NSAIDs for musculoskeletal pain.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Medicine, Research & Experimental
Hugo Ribeiro, Ines Rodrigues, Leonardo Napoleao, Luis Lira, Denise Marques, Manuel Verissimo, Jose Paulo Andrade, Marilia Dourado
Summary: This narrative review examines the safest NSAIDs to use in the elderly based on the best available evidence. Understanding patient characteristics and basic pharmacology can improve treatment safety and adherence.
BIOMEDICINE & PHARMACOTHERAPY
(2022)
Review
Orthopedics
Fan Zeng, Kang Wang, Hang Duan, Xiao-tong Xu, Gao-yan Kuang, Min Lu
Summary: This systematic review and meta-analysis evaluated the efficacy and safety of diacerein in patients with knee osteoarthritis (KOA). The results showed that diacerein had comparable efficacy to non-steroidal anti-inflammatory drugs (NSAIDs) in reducing pain indicators. Diacerein also outperformed NSAIDs in terms of global efficacy assessment and sustained effectiveness, with no significant difference in adverse events incidence. However, the majority of evidence quality was low, indicating the need for further high-quality studies.
JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH
(2023)
Review
Orthopedics
Nicola Veronese, Fiona Ecarnot, Sara Cheleschi, Antonella Fioravanti, Stefania Maggi
Summary: This scoping review investigates the potential benefits and synergistic effect of a combination of glucosamine sulfate (GS) and non-steroidal anti-inflammatory drugs (NSAIDs) in patients with knee osteoarthritis (OA). The review includes 5 studies and finds that the combination of GS plus NSAID yields significantly greater clinical benefits compared to either treatment alone, particularly in terms of pain reduction, function improvement, and regulation of joint damage.
BMC MUSCULOSKELETAL DISORDERS
(2022)
Article
Medicine, General & Internal
Haley Nakata, Tara Shelby, Jennifer C. Wang, Gabriel J. Bouz, Cory K. Mayfield, Daniel A. Oakes, Jay R. Lieberman, Alexander B. Christ, Nathanael D. Heckmann
Summary: This study aimed to assess the complications associated with the combinations of non-steroidal anti-inflammatory drugs (NSAIDs) in patients who underwent total joint arthroplasty (TJA). The study found that certain combinations of NSAIDs were associated with increased odds of acute kidney injury, stroke, and periprosthetic joint infection. Therefore, caution should be exercised when prescribing NSAIDs.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Orthopedics
Joon-Kiong Lee, Azlina A. Abbas, Tien-Eang Cheah, Ruslan Nazaruddin Simanjuntak, Sargunan Sockalingam, Sharifah Roohi
Summary: Osteoarthritis (OA) is a significant burden in many populations, with its prevalence expected to rise due to aging and increase in risk factors. Topical NSAIDs are recommended as an early treatment option for managing OA pain, but their use in Malaysia is low and not preferred by prescribers. This consensus recommendation provides guidance for healthcare practitioners on the use of topical NSAIDs in managing OA pain, emphasizing their efficacy, safety, and ease of use. It is recommended to advocate for early use of topical NSAIDs over oral NSAIDs for mild-to-moderate OA pain while involving patients in the decision-making process for optimal outcomes.
JOURNAL OF ORTHOPAEDIC RESEARCH
(2023)
Review
Environmental Sciences
Ewa Mulkiewicz, Daniel Wolecki, Klaudia Swiacka, Jolanta Kumirska, Piotr Stepnowski, Magda Caban
Summary: This review presents the current state of knowledge on the metabolic pathways of NSAIDs in organisms at various levels of biological organisation. The study found similarities in NSAIDs metabolism to that in mammals, as well as differences such as newly detected metabolites and phase III metabolism in plants. Some metabolites were found to exhibit higher toxicity than their parent forms.
SCIENCE OF THE TOTAL ENVIRONMENT
(2021)
Review
Medicine, General & Internal
M. Q. H. Leow, Q. Zheng, L. Shi, S. C. Tay, E. S. Y. Chan
Summary: Results from two trials show that compared to glucocorticoid injection, NSAID injection offered little to no benefit in the treatment of trigger finger. Specifically, there was no difference in resolution, symptoms, recurrence, total active motion, residual pain, participant-reported treatment success, or adverse events.
COCHRANE DATABASE OF SYSTEMATIC REVIEWS
(2021)
Article
Pharmacology & Pharmacy
Laura Grohs, Linhan Cheng, Saskia Coenen, Bassam G. Haddad, Astrid Buelow, Idil Toklucu, Lisa Ernst, Jannis Koerner, Guenther Schmalzing, Angelika Lampert, Jan-Philipp Machtens, Ralf Hausmann
Summary: This study found that NSAIDs can inhibit P2X3R and P2X2/3R subtypes, with Diclofenac being the most effective antagonist. The inhibition is mainly achieved through interaction with residues of the ATP-binding site. However, considering the rarely reached concentrations in therapeutic doses, the analgesic effect of NSAIDs may be minor compared to their high-potency cyclooxygenase inhibition.
FRONTIERS IN PHARMACOLOGY
(2023)
Review
Biochemistry & Molecular Biology
Gustavo Marinho Miranda, Vitoria Ohana Ramos e Santos, Jonatas Reis Bessa, Yanna C. F. Teles, Setondji Cocou Modeste Alexandre Yahouedehou, Marilda Souza Goncalves, Jaime Ribeiro-Filho
Summary: The incorporation of drugs into cyclodextrins has shown promising results in improving the pharmacological and biopharmaceutical properties of non-steroidal anti-inflammatory drugs. This systematic review identified 24 different NSAIDs, 12 types of CDs, and 60 distinct inclusion complexes, with meloxicam and beta-CD being the most studied combination.
Review
Pharmacology & Pharmacy
Hongjin Lai, Yi Liu, Juan Wu, Jie Cai, Hui Jie, Yuyang Xu, Senyi Deng
Summary: Inflammatory processes play a crucial role in innate immunity and tumor development in various malignancies. Targeting inflammation with pharmacotherapies, such as non-steroidal anti-inflammatory drugs (NSAIDs), has the potential to reduce the risk of carcinogenesis and enhance the effectiveness of anti-cancer treatments. However, the pharmacogenomic variability of NSAIDs can greatly impact their pharmacokinetics and therapeutic outcomes in cancer patients. Thus, a comprehensive understanding of the pharmacogenomic characteristics of NSAIDs and cancer-related inflammation is important for developing new strategies in cancer treatment.
FRONTIERS IN PHARMACOLOGY
(2022)
Review
Orthopedics
C. Zeng, M. Doherty, M. S. M. Persson, Z. Yang, A. Sarmanova, Y. Zhang, J. Wei, J. Kaur, X. Li, G. Lei, W. Zhang
Summary: Research shows that in the treatment of knee osteoarthritis, topical NSAIDs are more effective than acetaminophen for function improvement, and they are safer than other medications in both trials and real-world data.
OSTEOARTHRITIS AND CARTILAGE
(2021)
Review
Chemistry, Physical
Rodica Ana Ungur, Viorela Mihaela Ciortea, Laszlo Irsay, Alina Deniza Ciubean, Bogdana Adriana Nasui, Razvan Andrei Codea, Victoria Emilia Singurean, Oana Bianca Groza, Simona Cainap, Georgiana Smaranda Martis (Petrut), Cristin Borda, Ileana Monica Borda
Summary: NSAIDs are commonly used in knee osteoarthritis treatment, but they have negative environmental effects, while ultrasound therapy is effective for pain relief and has metabolic benefits for cartilage, making it a recommended alternative to NSAIDs for knee OA treatment.
Review
Biochemistry & Molecular Biology
Soumita Ghosh
Summary: Metabolomics is a valuable tool in understanding the side effects of NSAIDs and has the potential to identify drug targets for side effects mitigation. Researchers focus on metabolomics techniques, bio sample handling, and review of metabolomics studies in different biofluids and tissues related to NSAIDs. The altered pathways highlighted in the analysis, such as TCA cycle and amino acid metabolism, provide insights into the disease progression and pathogenesis influenced by NSAIDs.
Article
Immunology
Jing Zhang, Hongguang Sheng, Xiaoyi Tang, Panpan Xia, Zhangwang Li, Minxuan Xu, Jianyong Ma, Yunfeng Shen, Peng Yu, Xiao Liu
Summary: According to a post-hoc analysis from the ORCHID trial, the use of non-steroidal anti-inflammatory drugs (NSAIDs) in hospitalized American adult COVID-19 patients is not associated with worse clinical outcomes, including 28-day mortality or hospital discharge. Furthermore, a meta-analysis of 14 studies involving 48,788 COVID-19 patients showed that NSAID use had a survival benefit and decreased the risk of severe COVID-19.
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
(2022)
Letter
Medicine, Research & Experimental
Gordon McGregor, Harbinder Sandhu, Julie Bruce, Bartholomew Sheehan, David McWilliams, Joyce Yeung, Christina Jones, Beatriz Lara, Jessica Smith, Chen Ji, Elaine Fairbrother, Stuart Ennis, Peter Heine, Sharisse Alleyne, Jonathan Guck, Emma Padfield, Rachel Potter, James Mason, Ranjit Lall, Kate Seers, Martin Underwood
Article
Medicine, General & Internal
Peter David Henry Wall, Imran Ahmed, Claire Edwin, Muhamed M. Farhan-Alanie, Helen Parsons, Andrew James Price, Jane Warwick, Charles E. Hutchinson, Martin Underwood, Andrew Metcalfe
Summary: The study explores the use of tourniquets during total knee replacement surgery and their potential impact on thromboembolic events, cognitive decline, pain, and other adverse events. The results suggest that a full trial is feasible, with Montreal Cognitive Assessment (MoCA) being a suitable primary outcome to measure cognition, along with pain and adverse events, for future investigation in a large multicentre trial.
Editorial Material
Medicine, General & Internal
Martin Underwood, Colin Tysall
BMJ-BRITISH MEDICAL JOURNAL
(2021)
Article
Orthopedics
Siew Wan Hee, Dipesh Mistry, Tim Friede, Sarah E. Lamb, Nigel Stallard, Martin Underwood, Shilpa Patel
Summary: The study found that passive physical treatments are more suitable for younger patients with higher levels of disability and lower levels of psychological distress, while psychological treatments are more suitable for those with severe disability.
BMC MUSCULOSKELETAL DISORDERS
(2021)
Editorial Material
Medicine, General & Internal
Gustavo C. Machado, Christina Abdel-Shaheed, Martin Underwood, Richard O. Day
BMJ-BRITISH MEDICAL JOURNAL
(2021)
Article
Rehabilitation
ZiHeng Liew, Bruno Mazuquin, David R. Ellard, Eleni Karasouli, Stephen Drew, Chetan Modi, Howard Bush, Martin Underwood, Rebecca S. Kearney
Summary: The aim of the ARTISAN trial is to compare the clinical and cost-effectiveness of different physiotherapy management for people with a conservatively managed primary traumatic anterior shoulder dislocation. The intervention includes education, progressive exercise, and self-management strategies, delivered by a chartered physiotherapist within the first six weeks of injury.
Article
Medicine, General & Internal
Karen L. Barker, Jonathan Room, Ruth Knight, Susan Dutton, Francine Toye, Jose Leal, Nicola Kenealy, Michael Maia Schlussel, Gary Collins, David Beard, Andrew James Price, Martin Underwood, Avril Drummond, Sarah Lamb
Summary: This study aimed to evaluate whether a home-based rehabilitation programme offers superior outcomes to traditional outpatient physiotherapy for people assessed as being at risk of a poor outcome after knee arthroplasty. The results showed no significant differences between the two groups on either primary or secondary outcomes, indicating that the home-based rehabilitation programme was not superior to usual care.
Article
Medicine, General & Internal
Rebecca Kearney, Rebecca McKeown, Helen Parsons, Aminul Haque, Nick Parsons, Henry Nwankwo, James Mason, Martin Underwood, Anthony C. Redmond, Jaclyn Brown, Siobhan Kefford, Matthew Costa
Summary: This study compared the effectiveness of plaster cast immobilisation versus a removable brace for ankle fracture treatment in adults. The results showed no significant difference in the Olerud Molander ankle score between the two groups at 16 weeks. No clinically significant differences were found in other time points and secondary analyses.
BMJ-BRITISH MEDICAL JOURNAL
(2021)
Article
Medicine, General & Internal
Harbinder Kaur Sandhu, Jane Shaw, Dawn Carnes, Andrea D. Furlan, Colin Tysall, Henry Adjei, Chockalingam Muthiah, Jennifer Noyes, Nicole K. Y. Tang, Stephanie J. C. Taylor, Martin Underwood, Adrian Willis, Sam Eldabe
Summary: This study describes the design, development, and pilot of a multicomponent intervention aimed at supporting withdrawal of opioids for people with chronic nonmalignant pain. The intervention was developed by a multidisciplinary team with expertise in health behavior interventions, opioid tapering, pain management, IT programming, and software development. The final intervention package includes education, problem-solving, motivation, tailored planning, reflection, and monitoring for reducing opioid use.
Article
Pharmacology & Pharmacy
Yodit Seifu, Shahrul Mt-Isa, Kyle Duke, Margaret Gamalo-Siebers, William Wang, Gaohong Dong, John Kolassa
Summary: This study proposes a new trial design for evaluating the benefit and risk of a therapy. The design incorporates a composite endpoint consisting of both benefit and risk measures, taking into account all aspects of adverse events. The power and sample size requirements of this design are explored through simulation, and a case study using Dupixent study results is presented to demonstrate its potential in reducing sample size for pediatric studies.
JOURNAL OF BIOPHARMACEUTICAL STATISTICS
(2023)
Article
Medicine, General & Internal
Lauren Jade Ewington, Jason Gardosi, Ranjit Lall, Martin Underwood, Joanne D. Fisher, Sara Wood, Ryan Griffin, Kirsten Harris, Debra Bick, Katie Booth, Jaclyn Brown, Emily Butler, Kelly Fowler, Mandy Williams, Sanjeev Deshpande, Adam Gornall, Jackie Dewdney, Karen Hillyer, Simon Gates, Ceri Jones, Hema Mistry, Stavros Petrou, Anne-Marie Slowther, Adrian Willis, Siobhan Quenby
Summary: LGA fetuses have an increased risk of shoulder dystocia. The Big Baby Trial aims to determine whether induction of labor at 38(+0)-38(+4) weeks' gestation reduces the incidence of shoulder dystocia.
Article
Medicine, General & Internal
Giovanni E. Ferreira, Christina Abdel-Shaheed, Martin Underwood, Nanna B. Finnerup, Richard Day, Andrew McLachlan, Sam Eldabe, Joshua R. Zadro, Christopher G. Maher
Summary: This study provides a comprehensive overview of the efficacy, safety, and tolerability of antidepressants for different pain conditions. The results show that antidepressants are effective in some pain conditions, particularly proton pump inhibitors, postoperative pain, neuropathic pain, and fibromyalgia. However, there is insufficient evidence to support the efficacy of antidepressants in other pain conditions. A more nuanced approach is needed when prescribing antidepressants for pain conditions.
BMJ-BRITISH MEDICAL JOURNAL
(2023)
Review
Clinical Neurology
Annemarie de Zoete, Michiel R. de Boer, Sidney M. Rubinstein, Maurits W. van Tulder, Martin Underwood, Jill A. Hayden, Laurien M. Buffart, Raymond Ostelo
Summary: This study aimed to identify participant characteristics that moderate the effect of spinal manipulative therapy (SMT) on chronic low back pain. However, the results did not reveal any moderators that could help clinicians determine which patients are more likely to benefit from SMT compared to other treatments.
Article
Health Care Sciences & Services
Julie Bruce, Anower Hossain, Ranjit Lall, Emma J. Withers, Susanne Finnegan, Martin Underwood, Chen Ji, Chris Bojke, Roberta Longo, Claire Hulme, Susie Hennings, Ray Sheridan, Katharine Westacott, Shvaita Ralhan, Finbarr Martin, John Davison, Fiona Shaw, Dawn A. Skelton, Jonathan Treml, Keith Willett, Sarah E. Lamb
Summary: This study compared the clinical effectiveness and cost-effectiveness of different falls prevention interventions in primary care among individuals aged 70 years and older. The results showed that exercise was the most cost-effective treatment, resulting in a short-term reduction in falls risk.
HEALTH TECHNOLOGY ASSESSMENT
(2021)
Review
Anesthesiology
Graeme Wertheimer, Stephanie Mathieson, Christopher G. Maher, Chung-Wei Christine Lin, Andrew J. McLachlan, Rachelle Buchbinder, Sallie-Anne Pearson, Martin Underwood
Summary: The study found that a quarter of people with chronic noncancer pain reported using opioids between 1990 and 2017, with the proportion remaining stable over time. The use of weak opioids was more common than strong opioids. Geographical region was associated with opioid use, with lower use in Europe compared to North America.