The effect of NSAIDs on postfracture bone healing: a meta-analysis of randomized controlled trials.
The effect of NSAIDs on postfracture bone healing: a meta-analysis of randomized controlled trials.
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非甾体抗炎药对骨折后骨愈合的影响：随机对照试验的荟萃分析。
DOI：
10.1097/oi9.0000000000000092
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发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Bernstein M
中科院分区：
文献类型：
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作者：
Al Farii H;Farahdel L;Frazer A;Salimi A;Bernstein M
通过评价所有可用的关于该受试者的人体随机对照试验（RCT），确定非甾体抗炎药（NSAID）是否对骨愈合有不良影响。全面检索电子数据库（PubMed、MEDLINE和交叉引用），直至2018年10月，通过RCT比较接受NSAID患者与对照组的骨不连发生率。入选标准为纯英文研究，研究类型仅限于RCT。两名作者独立地从选定的研究中提取数据，并对收集的数据进行比较以验证一致性。骨不连是每项研究评价的主要结局。通过计算二分变量的比值比（OR），回归分析用于估计NSAID持续时间和类型的相对风险。通过结果方差的倒数对研究进行加权，并将固定效应模型用于所有分析。纳入了6项RCT（609例患者）。骨折后使用非甾体类抗炎药的患者骨不连的风险更高，OR为3.47。然而，一旦研究被归类为NSAID治疗的持续时间，与长期接受NSAID的患者（>4周）相比，短期接受NSAID的患者（<2周）未显示出任何显著的骨不连风险。与其他非甾体抗炎药相比，吲哚美辛与显著更高的骨不连率相关，OR范围为1.66 - 9.03，而其他非甾体抗炎药未显示出显著的骨不连风险。
To determine whether nonsteroidal anti-inflammatory drugs (NSAIDs) have an adverse effect on bone healing by evaluating all available human randomized controlled trials (RCTs) on this subject. A comprehensive search of electronic databases (PubMed, MEDLINE, and Cross-References) until October 2018 comparing the occurrence of nonunion in patients who received NSAIDs to the control group through RCTs. Inclusion criteria were English-only studies, and the type of studies was restricted to RCTs. Two authors independently extracted data from the selected studies, and the data collected were compared to verify agreement. Nonunion was the main outcome evaluated in each study. Regression analysis was used to estimate the relative risk comparing the duration and the type of NSAIDs by calculating the odds ratio (OR) for dichotomous variables. Studies were weighed by the inverse of the variance of the outcome, and a fixed-effects model was used for all analyses. Six RCTs (609 patients) were included. The risk of nonunion was higher in the patients who were given NSAIDs after the fracture with an OR of 3.47. However, once the studies were categorized into the duration of treatment with NSAIDs, those who received NSAIDs for a short period (<2 weeks) did not show any significant risk of nonunion compared to those who received NSAIDs for a long period (>4 weeks). Indomethacin was associated with a significant higher nonunion rate and OR ranging from 1.66 to 9.03 compared with other NSAIDs that did not show a significant nonunion risk.