COMPARISON OF AN ANTIINFLAMMATORY DOSE OF IBUPROFEN, AN ANALGESIC DOSE OF IBUPROFEN, AND ACETAMINOPHEN IN THE TREATMENT OF PATIENTS WITH OSTEOARTHRITIS OF THE KNEE
COMPARISON OF AN ANTIINFLAMMATORY DOSE OF IBUPROFEN, AN ANALGESIC DOSE OF IBUPROFEN, AND ACETAMINOPHEN IN THE TREATMENT OF PATIENTS WITH OSTEOARTHRITIS OF THE KNEE
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DOI：
10.1056/nejm199107113250203
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发表时间：
1991-07-11
影响因子：
158.5
通讯作者：
RYAN, SI
中科院分区：
文献类型：
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作者：
BRADLEY, JD;BRANDT, KD;RYAN, SI
背景。最佳的短期，对症治疗膝关节骨关节炎尚未完全确定。因此，我们比较了非甾体抗炎药布洛芬的疗效，无论是抗炎剂量（高剂量）还是镇痛剂量（低剂量），对乙酰氨基酚，一种纯镇痛药。在一项随机双盲试验中，184名因骨关节炎引起的慢性膝关节疼痛患者每天服用2400或1200毫克布洛芬或4000毫克对乙酰氨基酚。他们在研究开始前的三到七天的洗脱期后进行评估，并在治疗四周后再次进行评估。结果的主要测量包括斯坦福健康评估问卷的疼痛和残疾量表得分（可能的得分范围，0到3），休息时疼痛和步行时疼痛的视觉模拟量表得分，步行50英尺（15米）所需的时间，以及医生对患者关节炎的整体评估。78%的患者完成了四周的治疗。在三个治疗组中，由于不依从性或不良事件而未能完成试验的情况没有显著差异。所有三组在所有主要结果变量上都有改善，并且在大多数变量上两组的改善程度没有显著差异。对乙酰氨基酚组疼痛评分的平均改善（改变）为0.33(95%可信区间，0.14 ~ 0.52)，低剂量布洛芬组为0.30(95%可信区间，0.09 ~ 0.51)，高剂量布洛芬组为0.35（95%可信区间，0.13 ~ 0.57）。三组的副作用均较小且相似。在短期，对症治疗膝骨关节炎，对乙酰氨基酚的疗效与布洛芬相似，无论是镇痛剂量还是抗炎剂量。
Background. The optimal short-term, symptomatic therapy for osteoarthritis of the knee has not been fully determined. Accordingly, we compared the efficacy of a nonsteroidal antiinflammatory drug, ibuprofen, given in either an antiinflammatory dose (high dose) or an analgesic dose (low dose), with that of acetaminophen, a pure analgesic.Methods. In a randomized, double-blind trial, 184 patients with chronic knee pain due to osteoarthritis were given either 2400 or 1200 mg of ibuprofen per day or 4000 mg of acetaminophen per day. They were evaluated after a washout period of three to seven days before the beginning of the study, and again after four weeks of treatment. The major measures of outcome included scores on the pain and disability scales of the Stanford Health Assessment Questionnaire (range of possible scores, 0 to 3), scores on the visual-analogue scales for pain at rest and pain while walking, the time needed to walk 50 ft (15 m), and the physician's global assessment of the patient's arthritis.Results. Seventy-eight percent of the patients completed four weeks of therapy. No significant differences were noted among the three treatment groups with respect to failure to complete the trial because of noncompliance or adverse events. All three groups had improvement in all major outcome variables, and the groups did not differ significantly in the magnitude of improvement in most variables. The mean improvement (change) in the scores on the pain scale of the Health Assessment Questionnaire was 0.33 with acetaminophen (95 percent confidence interval, 0.14 to 0.52), 0.30 with the low dose of ibuprofen (95 percent confidence interval, 0.09 to 0.51), and 0.35 with the high dose of ibuprofen (95 percent confidence interval, 0.13 to 0.57). Side effects were minor and similar in all three groups.Conclusions. In short-term, symptomatic treatment of osteoarthritis of the knee, the efficacy of acetaminophen was similar to that of ibuprofen, whether the latter was administered in an analgesic or an antiinflammatory dose.