Efficacy and gastrointestinal adverse reaction of non-steroidal anti-inflammatory drugs in Chinese patients with osteoarthritis: network Meta-analysis

Objective To compare and evaluate the efficacy and gastrointestinal adverse reaction of seven kinds of non-steroidal anti-inflammatory drugs for the treatment of Chinese patients with osteoarthritis by using network meta-analysis. Methods Controlled trials on non-steroidal anti-inflammatory drugs for Chinese patients with osteoarthritis were searched in PubMed, Cochrane Library, CNKI, Wanfang, and VIP Database. Statistical analysis was performed by Stata 13.1 and WinBUGS1.4.3 software. Results Sixteen eligible studies were identified involving 1 612 Chinese patients with osteoarthritis. The rank probability plot and the surface under the cumulative ranking (SUCRA) calculation results suggested that in terms of the efficacy of pain relief, drugs were ranked in descending order as follows: etoricoxib(76.2%)> diclofenac(64.6%)> celecoxib(58.2%)>loxoprofen(52.5%)> ibuprofen(36.8%)>meloxicam(11.7%). With regard to adverse reaction of the gastrointestinal tract, drugs ranked by the severity of adverse reactions from mild to severe were as follows: etoricoxib(74.3%)> celecoxib(72.1%)>meloxicam(70.1%)> naproxen(41.7%)> diclofenac(24.2%)> ibuprofen(17.5%). Conclusion The results suggest that etoricoxib is the best in terms of the efficacy and gastrointestinal adverse reaction when compared with other six types of non-steroidal anti-inflammatory drugs for the treatment of Chinese patients with osteoarthritis. Key words: Osteoarthritis; Anti-inflammatory agents, non-steroidal; Randomized controlled trial; Meta-analysis