REB methodology application on topical and oral NSAIDS' therapeutic benefit evaluation on acute pain related to musculoskeletal injuries
Abstract
Introduction: Acute musculoskeletal injuries are a common reason for primary care consultations. Nonsteroidal anti-inflammatory drugs (NSAIDs) are currently used in this context. Recent meta-analyses (M-A) showed a better benefit--risk profile for topical NSAIDs and no superiority of oral NSAIDs over paracetamol alone or in combination in terms of pain relief. It seems appropriate to evaluate rigorously NSAIDs' benefit-risk balance to support more consistent recommendations and promote appropriate evidence-based use of this drug class in trauma care.
Objective: This study's objective is to assess the efficacy and benefit-risk balance of oral and topical NSAIDs in the management of acute pain related to acute musculoskeletal injuries.
Materials and methods: A systematic review was conducted using public databases Medline (PubMed), CENTRAL (Cochrane) and Embase. Controlled randomised trials (RCTs) evaluating oral and topical NSAIDs (diclofenac, ibuprofen, ketoprofen and naproxen) for the treatment of acute pain from minor soft tissue injuries were included. These RCTs are from 2020 meta-analysis by Busse et al. bibliographic references and from complementary research from January 2020 to December 2023. Primary outcome is short-term pain (from 30minutes to 7days). Secondary outcomes are pain at rest, pain on movement (preferably on day 3), and safety analysis for oral and topical forms. Risk of bias was assessed using the Risk of Bias version 2 (RoB2) tool. Meta-analyses were…
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