NSAIDS Work For Menses Pain But Carry Risk of Side Effects

MedicalResearch.com Interview with:
Jane Marjoribanks
Obstetrics and Gynaecology
University of Auckland, National Women’s Hospital,
Auckland, New Zealand

MedicalResearch: What is the background for this study?

Response: This study is a systematic review of all randomised evidence published up to January 2015 on the effectiveness and safety of non-steroidal inflamatory drugs (NSAIDs) used to treat primary dysmenorrhoea (period pain). It includes 80 randomised controlled trials (total 5820 participants), which compare 20 different NSAIDs versus placebo, other NSAIDs or paracetamol.

The review was prepared by researchers from the Cochrane Collaboration, which is a global independent network of contributors (37,000 from more than 130 countries) who gather and summarize the best evidence from research to produce credible, accessible health information that is free from commercial sponsorship and other conflicts of interest.

MedicalResearch: What are the main findings?

Response: The main findings are that NSAIDs appear to be very effective in relieving period pain. The evidence suggests that if 18% of women taking placebo achieve moderate or excellent pain relief, between 45% and 53% taking NSAIDs will do so. NSAIDs appear to work better than paracetamol, but it is unclear whether any one NSAID is safer or more effective than others.

NSAIDs commonly cause adverse effects (side effects), including indigestion, headaches and drowsiness. The evidence suggests that if 10% of women taking placebo experience side effects, between 11% and 14% of women taking NSAIDs will do so.

Based on two studies that made head-to-head comparisons, there was no evidence that newer types of NSAID (known as COX-2-specific inhibitors) are more effective for the treatment of dysmenorrhoea than traditional NSAIDs (known as non-selective inhibitors), nor that there is a difference between them with regard to adverse effects.

MedicalResearch: What should clinicians and patients take away from your report?

Response: NSAIDs appear to be a very effective treatment for dysmenorrhoea, but women using them need to be aware of the substantial risk of adverse effects. It is unclear which (if any) individual NSAID is the safest and most effective for the treatment of dysmenorrhoea. We rated the quality of the evidence as low for most comparisons, mainly due to poor reporting of study methods.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Response: We suggest that a comparison of combination therapies versus NSAIDs alone would be a useful topic for a further systematic review.

Citation:

Marjoribanks J, Ayeleke R, Farquhar C, Proctor M. Nonsteroidal anti-inflammatory drugs for dysmenorrhoea. Cochrane Database of Systematic Reviews 2015, Issue 7. Art. No.: CD001751. DOI: 10.1002/14651858.CD001751.pub3

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Jane Marjoribanks (2015). NSAIDS Work For Menses Pain But Carry Risk of Side Effects 

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