非甾体抗炎药治疗我国中老年骨关节炎疗效和安全性的网状Meta分析

Network Meta-analysis on efficacy and safety of non-steroidal antiinflammatory drugs for osteoarthritis in middle aged and old people

目的系统评价不同非甾体抗炎药(NSAIDs)治疗中国中老年骨关节炎(OA)患者的疗效和安全性。方法检索PubMed、Cochrane Library、CNKI、WanFang Data和VIP数据库,搜集关于NSAIDs治疗中国中老年OA患者的随机对照试验,检索时限均从建库至2020年11月17日。由两位研究人员独立进行文献筛选、数据提取和文献质量评价,采用R3.6.0软件进行贝叶斯网状Meta分析。结果共纳入28项研究,包含2531例患者。针对末次随访疼痛视觉模拟评分(VAS)这一指标,概率排序图显示,口服依托考昔末次随访疼痛VAS评分最低的概率最大(88.55%);总有效率方面,依托考昔口服剂型排第1位的概率最高(92.49%);安全性方面,双氯芬酸钠贴片不良反应发生率最低的概率最大(59.10%)。结论本研究结果显示,口服依托考昔治疗中国中老年OA患者的疗效更好,可明显减缓患者疼痛,而双氯芬酸钠贴片的安全性更好。

Objective To systematically evaluate the efficacy and safety of different non-steroidal anti-inflammatory drugs(NSAIDs)in middle-aged and old Chinese patients with osteoarthritis(OA).Methods A systematic literature search was conducted through PubMed,Cochrane Library,CNKI,Wan Fang Data and VIP databases to collect randomized controlled trials with non-steroidal anti-inflammatory drugs in middle-aged to old Chinese OA patients.The search time was from the establishment of the database to November 17,2020.Two researchers independently carried out literature screening,data extraction and literature quality evaluation.Bayesian network meta-analysis was conducted with R3.6.0 software.Results 28 RCTs were included with 2531 patients.Based on the last follow-up pain visual analogue scale(VAS)score,the ranking chart showed that Etoricoxib had the highest probability of having the lowest pain VAS score(88.55%).In terms of total effective rate,the ranking chart showed that the probability of Etoricoxib as first choice was the highest(92.49%).As far as safety,diclofenac sodium patch had the lowest adverse effects rate(59.10%).Conclusion The results of this study indicated that Etoricoxib was the most effective treatment for middleaged and old Chinese OA patients.It can significantly reduce the OA pain.Diclofenac sodium patch had the least adverse effects.