caa a22 4500 605459517 CHVBK 20210128100234.0 cr unu---uuuuu 210128e20150801xx s 000 0 eng 10.1007/s00167-014-2851-6 doi (NATIONALLICENCE)springer-10.1007/s00167-014-2851-6 Non-steroidal anti-inflammatory drugs (NSAIDs) for treating acute ankle sprains in adults: benefits outweigh adverse events [Elektronische Daten] [Michel van den Bekerom, Arnout Sjer, Matthijs Somford, Gythe Bulstra, Peter Struijs, Gino Kerkhoffs] 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. Springer-Verlag Berlin Heidelberg, 2014 Ankle sprain nationallicence NSAID nationallicence Injury nationallicence Efficacy nationallicence Adverse events nationallicence Systematic review nationallicence van den Bekerom Michel OLVG, Amsterdam, The Netherlands aut Sjer Arnout MCA, Alkmaar, The Netherlands aut Somford Matthijs Amphia hospital, Breda, The Netherlands aut Bulstra Gythe OLVG, Amsterdam, The Netherlands aut Struijs Peter AMC, Amsterdam, The Netherlands aut Kerkhoffs Gino AMC, Amsterdam, The Netherlands aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/8(2015-08-01), 2390-2399 0942-2056 23:8<2390 2015 23 167 https://doi.org/10.1007/s00167-014-2851-6 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 review-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-014-2851-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- van den Bekerom Michel OLVG, Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- Sjer Arnout MCA, Alkmaar, The Netherlands aut NATIONALLICENCE 700 1- Somford Matthijs Amphia hospital, Breda, The Netherlands aut NATIONALLICENCE 700 1- Bulstra Gythe OLVG, Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- Struijs Peter AMC, Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- Kerkhoffs Gino AMC, Amsterdam, The Netherlands aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/8(2015-08-01), 2390-2399 0942-2056 23:8<2390 2015 23 167