Non-steroidal anti-inflammatory drugs (NSAIDs) for treating acute ankle sprains in adults: benefits outweigh adverse events

Verfasser / Beitragende:
[Michel van den Bekerom, Arnout Sjer, Matthijs Somford, Gythe Bulstra, Peter Struijs, Gino Kerkhoffs]
Ort, Verlag, Jahr:
2015
Enthalten in:
Knee Surgery, Sports Traumatology, Arthroscopy, 23/8(2015-08-01), 2390-2399
Format:
Artikel (online)
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024 7 0 |a 10.1007/s00167-014-2851-6  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00167-014-2851-6 
245 0 0 |a Non-steroidal anti-inflammatory drugs (NSAIDs) for treating acute ankle sprains in adults: benefits outweigh adverse events  |h [Elektronische Daten]  |c [Michel van den Bekerom, Arnout Sjer, Matthijs Somford, Gythe Bulstra, Peter Struijs, Gino Kerkhoffs] 
520 3 |a Purpose: In the recent clinical guideline for acute lateral ankle sprain, the current best evidence for diagnosis, treatment and prevention strategies was evaluated. Key findings for treatment included the use of ice and compression in the initial phase of treatment, in combination with rest and elevation. A short period of taking non-steroidal anti-inflammatory drugs (NSAIDs) may facilitate a rapid decrease in pain and swelling can also be helpful in the acute phase. The objective was to assess the effectiveness and safety of oral and topical NSAID in the treatment for acute ankle sprains. Methods: Randomised controlled trials comparing oral or topic NSAID treatment with placebo or each other were included. Primary outcome measures were pain at rest or at mobilisation and adverse events. Trials were assessed using the Cochrane risk of bias tool. Results: Twenty-eight studies were included, and 22 were available for meta-analysis. Superior results were reported for oral NSAIDs when compared with placebo, concerning pain on weight bearing on short term, pain at rest on the short term, and less swelling on short- and intermediate term. For topical NSAIDs, superior results compared with placebo were found for pain at rest (short term), persistent pain (intermediate term), pain on weight bearing (short- and intermediate term) and for swelling (short and intermediate term). No trials were included comparing oral with topic NSAIDs, so conclusions regarding this comparison are not realistic. Conclusions: The current evidence is limited due to the low number of studies, lack of methodological quality of the included studies as well as the small sample size of the included studies. Nevertheless, the findings from this review support the use of NSAIDs for the initial treatment for acute ankle sprains. Level of evidence: Meta-analysis of RCTs, Level I. 
540 |a Springer-Verlag Berlin Heidelberg, 2014 
690 7 |a Ankle sprain  |2 nationallicence 
690 7 |a NSAID  |2 nationallicence 
690 7 |a Injury  |2 nationallicence 
690 7 |a Efficacy  |2 nationallicence 
690 7 |a Adverse events  |2 nationallicence 
690 7 |a Systematic review  |2 nationallicence 
700 1 |a van den Bekerom  |D Michel  |u OLVG, Amsterdam, The Netherlands  |4 aut 
700 1 |a Sjer  |D Arnout  |u MCA, Alkmaar, The Netherlands  |4 aut 
700 1 |a Somford  |D Matthijs  |u Amphia hospital, Breda, The Netherlands  |4 aut 
700 1 |a Bulstra  |D Gythe  |u OLVG, Amsterdam, The Netherlands  |4 aut 
700 1 |a Struijs  |D Peter  |u AMC, Amsterdam, The Netherlands  |4 aut 
700 1 |a Kerkhoffs  |D Gino  |u AMC, Amsterdam, The Netherlands  |4 aut 
773 0 |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/8(2015-08-01), 2390-2399  |x 0942-2056  |q 23:8<2390  |1 2015  |2 23  |o 167 
856 4 0 |u https://doi.org/10.1007/s00167-014-2851-6  |q text/html  |z Onlinezugriff via DOI 
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900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a review-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s00167-014-2851-6  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a van den Bekerom  |D Michel  |u OLVG, Amsterdam, The Netherlands  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Sjer  |D Arnout  |u MCA, Alkmaar, The Netherlands  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Somford  |D Matthijs  |u Amphia hospital, Breda, The Netherlands  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Bulstra  |D Gythe  |u OLVG, Amsterdam, The Netherlands  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Struijs  |D Peter  |u AMC, Amsterdam, The Netherlands  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Kerkhoffs  |D Gino  |u AMC, Amsterdam, The Netherlands  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/8(2015-08-01), 2390-2399  |x 0942-2056  |q 23:8<2390  |1 2015  |2 23  |o 167