Isonixin$ or Kebuzone$ or Ketoprofen$ or Orudis or oruvail or Ketorolac$ or toradol or Lonazolac$ or Lornoxicam$ or Xefo or Loxoprofen$).mp. Proquazone$ or Ramifenazone$ or Sulindac$ .. or Clinoril or Tenoxicam$ or Mobiflex or Tiaprofenic$ or Surgam or Tiaramid$ or Tolfenamic$ or Clotam or Tolmetin$ or Zaltoprofen$).mp. 34; hydrogen potassium adenosine triphosphatase inhibitor$". eg cimetidine$ or famotidine$ or nizatidine$ or ranitidine$). eg dispamet or tagamet or algitec or pepcid or axid or zantac or piloride). eg omeprazole$ or lansoprazole$ or pantoprazole $ or rabeprazole$).mp. losec or zoton or protium or pariet).mp. trial$ or comparison$ or control$).tw. blind$ or clinic$ or placebo).tw. cohort$ or quintile$ or quartile$ or tertile of $.
Proquazone$ or Ramifenazone$ or Sulindac$ .. or Clinoril or Tenoxicam$ or Mobiflex or Tiaprofenic$ or Surgam or Tiaramid$ or Tolfenamic$ or Clotam or Tolmetin$ or Zaltoprofen$).mp. exp diclofenac/ or exp diflunisal/ or exp epirizol/ or exp etodolac/ or exp fenoprofen/. or exp flufenamic acid/ or exp flurbiprofen/ or exp ibuprofen/ or exp indomethacin/ or exp ketoprofen/ or exp ketorolac/ or exp ketorolac tromethamine/ or exp meclofenamic acid/ or exp mefenamic acid/ or exp naproxen/ or exp niflumic acid/ or exp phenylbutazone/ or exp piroxicam/ or exp sulindac/ or exp tolmetin/. 34; hydrogen potassium adenosine triphosphatase inhibitor$". eg cimetidine$ or famotidine$ or nizatidine$ or ranitidine$). eg dispamet or tagamet or algitec or pepcid or axid or zantac or piloride). eg omeprazole$ or lansoprazole$ or pantoprazole $ or rabeprazole$).mp losec or zoton or protium or pariet).mp exp burimamide/ or exp cimetidine/ or exp famotidine/ or exp methiamide/ or exp misoprostol/ or exp nizatidine/ or exp omeprazole/ or exp ranitidine / .control$ or prospective$ or voluntary$).ti, ab. 34; hydrogen potassium inhibitor of adenosine triphosphatase$".mp. cimetidine$ or famotidine$ or nizatidine$ or . ranitidine$).mp. dispamet or tagamet or algitec or pepcid or axid or zantac or pylorid).mp. omeprazole$ or lansoprazole$ or pantoprazole$ or rabeprazole$).mp. losec or zoton or protium or pariet).mp. mp=title, abstract, subject titles, drug trade name, original title, device manufacturer, drug manufacturer name]. experimental$ or comparative$ or control$).tw. blind$ or clinic$ or placebo).tw. cohort$ or quintile$ or quartile$ or tertile$.
We would also like information that would allow us to classify the study according to our methodological criteria and identify any missing data or studies
Ibuprofen Arthrofen, Lidifen, Ebufac, Rimafen, Motrin, Nurofen, Galprofen, Orbifen, Brufen, Fenbid, Avallone, Brufen, Dismenol Nieuw, Dolgit, Dolibu, Dolofort, Doloren, Duafen, Ibudol, Ibupron, Iburem, Imbun, Kratalgin, Nurofen, Seractyl, Tabcin, Urem, ACT-3, Actiprofen, Raphene, Tri-profen, Bufedone, Dolgit, Dolophine, Exidol, Ibu-Slow, Inabrin, Malafene, Motrin, Advil, Mediprene, Novo-profen, Algifene, Analgyl, Ergix, Fenalgisch, Gelufen, Nureflex, Oralfen, Shark, Actren, Anco, Cesra, Contraneural, Dentigoa, Dignoflex, Dimidone, Dismenol, Dolgit, Doloneos, Dolo-Dolgit, Dolo-Puren, Dolormin, Dura-Ibu, Duribuprofen, Dysdolen, Esprenit, Exneural, Fibraflex, Gynofug, Ibol, Ibu, Ibu-Attritin, Ibu-Vivimed, Ibubest, Ibubeta, Ibuflam, Ibufug, Ibuhexal, Ibumerck, Ibuphlogont, Ibuprof, Ibutad, Imbun, Jenaprofen, Contagripp Mono, Logomed Schmerz, Mensoton, Mobilat, Novogent, Optalidon, Opturem, Parsal, Pfeil, Schmerz-Dolgit, Seclodin, Stadasan, Tabalon, Temple, Togal N, Trauma-dolgit, Thrombufen, Urem, Bufigen, Cunil, Melphen, Proflex, Aciryl, Arfen, Artene, Asepsal, Benflogin , Brufort, Dolocyl, Faspic, Flubenil, Focus, Gineflor, Ginenorm, Inabrin, Cos, Moment, Neo-Mindol, Prontalgin, Femapirin, Ibosure, Ibumetin, Nerofen, Zafen, Ibux, Abbifen, Adfen, Antiflam, Betagesic, Betaprofen, Brugesic , Clinofen, Dynofen, Ibopain, Ibufarm, Inza, Magnatex, Ranfen, Rofen, Solufen, Algiacidin, Algisan, Altior, Cusialgil, Dalsy, Doctril, Dolocyl, Dorival, Ediluna, Spidifen, Evasprin, Faspic, Femidol, Ibenone, Encefal, Isdol , Kalma, Leonal, Librofem, Liderfem, Lisi-budol, Medipren, Neobrufen, Noalgil, Pocyl, Sadefen, Solufena, Spidifen, Todalgil, Duobrus, Algifor, Antalgit, Bufeno, Dismenol, Irfen, Neo-Helvagit, Panax N, Redufen, Serviprofen, Spedifen, Dynafed IB, Excedrin IB, Genpril, Haltran, Ibufon, Ibuprohm, Medipren, Menadol, Midol IB, Nuprin, Trendar.
B) Non-NSAID gastroprotective agents, proprietary names
An individually randomised controlled trial?
In adults (18 years plus, not healthy volunteers) who have taken NSAIDs for at least 3 weeks (21 days)?
Comparing
- Older NSAIDs plus H 2 RAs compared with older NSAIDs (alone or with placebo gastroprotection)
- Older NSAIDs plus PPIs compared with older NSAIDs (alone or with placebo gastroprotection)
- Older NSAIDs plus misoprostol compared with older NSAIDs (alone or with placebo gastroprotection)
- Cox-2 inhibitors compared with older NSAIDs alone 5. Comparing any of the four gastroprotective strategies above
Are doses at least the minimum recommended daily prescribing dose as per BNF in at least 2 arms? (exclude less than minimum daily
Older NSAIDs plus PPIs compared with older NSAIDs (alone or with placebo gastroprotection)
Older NSAIDs (alone or with placebo gastroprotection) 3. Older NSAIDs plus PPIs
Older NSAIDs plus misoprostol 5. Cox-2 inhibitors
Selection bias
Performance bias
Detection bias
Attrition bias
Notes on allocation concealment
205Concomitant use of 3a
CONTROL Number eligible
EACH CATEGORY)
GIVE DENOMINATOR Serious GI complications
GIVE DENOMINATOR Symptomatic ulcers (gastric,
CONTROL Quality of life
GIVE DENOMINATOR GI symptoms (nausea,
GIVE DENOMINATOR Assume each GI symptom
207Anaemia
GIVE DENOMINATOR Occult bleeding
GIVE DENOMINATOR Economic (YES/NO)
GIVE DENOMINATOR Subgroup analyses?
Risk factors: history of PUBs: a 0, b 0 Concomitant use of corticosteroids: a 0, b 0 FUNDING Funded by: not stated Contact person affiliation author: Krankenhaus Schwetzingen, Schwetzingen Statistician affiliation: unclear Affiliation to trial administrator: unclear No. Risk factors: CVD: a 0, b 0 FUNDING Funded by: not stated Affiliation of contact author: Sacco University Hospital, Italy Affiliation of statistician: unclear Affiliation of trial administrator: unclear No. Risk factors: not disclosed FUNDING Funded by: not disclosed Affiliation of contact author: Rheumaklinik Bad Rappenau, Germany Affiliation with statistician: unclear Affiliation with trial administrator: unclear Nr.
Risk factors: none CVD: a 0, b 0 renal/hepatic disease: a 0, b 0 FUNDING Funded by: unclear Affiliation of contact author: unclear Affiliation of statistician: unclear Affiliation of trial administrator: unclear No. Risk factors: concomitant anticoagulants a 0, b 0 FUNDING Funded by: not stated Affiliation of contact author: address is Searle, Italy Affiliation of statistician: unclear Affiliation of trial administrator: unclear No. Risk factors: no details FUNDING Funded by: not stated Affiliation of contact author: City Hospital, Nottingham, UK Affiliation of statistician: unclear Affiliation of trial administrator: unclear No.
Risk factors: no details FUNDING Funded by: not stated Affiliation of contact author: unclear Affiliation of statistician: unclear Affiliation of trial administrator: unclear No. Risk factors: kidney/hepatic disease: a0, b 0 FUNDING Funded by: not stated Affiliation of contact author: no contact author stated Affiliation of statistician: unclear Affiliation of trial administrator: unclear No. Risk factors: concomitant use of anticoagulants: a 0, b 0 CVD: a 0, b 0 renal/hepatic disease: a 0, b 0 FUNDING Funded by: not stated Affiliation of contacting author: Freeman Hospital, Newcastle, UK Affiliation of statistician: unclear Affiliation of study administrator: unclear No.
Risk factors: CVD: a 0, b 0 renal/hepatic disease: a 0, b 0 FUNDING Funded by: not declared Contact author affiliation: University of Cagliari, Italy Statistician affiliation: unclear Study administrator affiliation : unclear No. Risk factors: concomitant use of anticoagulants: a 0, b 0 FUNDING Funded by: Wyeth-Ayerst Laboratories Contact author affiliation: University of Chile Statistician affiliation: unclear Study administrator affiliation: unclear No. Risk factors: severe renal/hepatic disease : a 0, b 0 FUNDING Funded by: not declared Contact author affiliation: Universidad de la Republica, Montevideo Statistician affiliation: unclear Study administrator affiliation: unclear Nr.
Risk factors: no details FUNDING Funded by: not stated Affiliation of contact author: Dr Karl Thomae, Biberach/riss, Germany Affiliation of statistician: unclear Affiliation of study administrator: unclear No. Risk factors: >1NSAID: a 0, b 0 FUNDING Funded by: not stated Affiliation of contact author: De Wever Hospital, Netherlands Affiliation of statistician: unclear Affiliation of trial administrator: unclear No. Risk factors: history of ulcers: a 56, b 62 FUNDING Funded by:GD Searle Affiliation of contact author: university of Miami, USA Affiliation of statistician: unclear Affiliation of study administrator: unclear No.
Risk factors: History of ulcers or erosions: All participants FUNDING Funded by: Not stated Contact author affiliation: Duke University Medical Center, USA Statistician affiliation: Unclear Trial administrator affiliation: Unclear No.
Funnel plots and related inferential methods were used to assess whether there was evidence of small study effects, including publication bias.34 These were conducted using StatsDirect software, using the tests of Egger and colleagues35 and Begg and Mazumdar36. All of these methods have low power to detect small study effects (including possible bias), with few studies reporting this. a) H2RA versus placebo, endoscopic ulcers.
Bias indicators
Bias indicators
343 Absolute risk reduction (ARR) or risk difference is the risk in the intervention group minus the risk in the.
343Absolute risk reduction (ARR) or risk difference is the risk in the intervention group minus the risk in the
343 Absolute risk reduction (ARR) or risk difference is the risk in the intervention group minus the risk in. intervention intervention control control lower upper geneity limit limit p-value Cox-2 preferences vs Cox-1. H2RA vs Serious GI Baseline GI risk No usable data for subgrouping. placebo events Baseline age No usable data for subgrouping. Symptomatic baseline GI risk No usable data for subgrouping. wounds Baseline age No usable data for subgrouping. events Base age No usable data for subgrouping.
Basic GI Symptomatic Risk No data available for subgrouping. ulcers Age of onset No data available for subgrouping.
Quality of life data
Economic evaluations
To compare the cost-effectiveness of misoprostol prophylaxis versus no prophylaxis in the treatment of patients with osteoarthritis and NSAID-associated abdominal pain A decision-analytic model (decision tree) was used to derive the cost-effectiveness of the two treatment strategies . This was calculated in terms of cost per episode of gastric ulcer disease averted, unilateral SA was used to test uncertainty Clinical: synthesis of previously published studies. This was calculated in terms of cost per GI event avoided, and one-way SA was used to test for uncertainty.
To compare the cost-effectiveness/usefulness of strategies for treating patients with osteoarthritis. The three treatment strategies were (i) prophylaxis for all NSAID users, (ii) prophylaxis for older NSAID users, and (iii) no prophylaxis for NSAID users. A decision An analytical (decision tree) model was used to derive the cost-utility of the treatment options. To compare the cost-effectiveness of a fixed combination of diclofenac and misoprostol against diclofenac in the treatment of patients with RA. To derive the cost-effectiveness of the treatment options, a deterministic decision analytic (decision tree) model was used. This was calculated in terms of cost per LYG and cost per QALY gain.
To compare the cost-effectiveness of misoprostol for NSAID-induced GI injury versus no misoprostol (placebo) The two treatment options were compared in three populations: (i) the population in the MUCOSA trial (8843 patients); 88 (ii) patients with a history of peptic ulcer disease; (iii) patients over 65 years of age A decision-analytic model was used to derive the cost-effectiveness of the two treatment options. This was calculated in terms of cost per year of life saved, and the cost per specific serious GI event avoided one-way SA was used to test for uncertainty. The Arthritis Cost Consequences Evaluation System (ACCES) model was used to derive the cost-effectiveness of alternative treatment options.
To compare the incremental cost-effectiveness of rofecoxib versus non-selective NSAIDs in the treatment of osteoarthritis patients aged > 65 years in Ontario, Canada A decision-analytic model (decision tree) was used to derive the cost-effectiveness of both of them. drugs. To assess the cost-effectiveness of rofecoxib versus non-selective NSAIDs in the treatment of patients with OA. A decision-analytic model (decision tree) was used to derive the cost-effectiveness of the two health technologies.
