Effects of prescription nonsteroidal antiinflammatory drugs on symptoms and disease progression among patients with knee osteoarthritis

Lapane KL, Yang S, Driban JB, et al. · Arthritis & Rheumatology

Sustained prescription NSAID use, reported at all three annual assessments by 25 of 1,846, showed non-significant trends toward better pain (−0.88, 95% CI −2.22 to 0.46), stiffness (−0.72, −1.56 to 0.12) and function (−4.27, −8.84 to 0.31), and 0.28 mm less joint-space narrowing (−0.06 to 0.62) — no evidence of accelerated radiographic progression in this OAI analysis. Use reported at one or two assessments moved nothing.

Population

Osteoarthritis Initiative participants with knee OA (1,846 for symptoms; 1,116 for radiographs) analyzed as new users with marginal structural models

Intervention

Prescription NSAID use, short-term vs sustained

Comparator

Non-use

Limitations

Observational despite causal-inference modeling; confidence intervals wide and cross zero, on 25 sustained users; prescription NSAIDs only, OTC ibuprofen use not captured as exposure, and no dose data. Funded by the National Heart, Lung and Blood Institute, on a cohort co-funded by Merck, Novartis, GlaxoSmithKline and Pfizer.