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Review: paracetamol reduces pain in osteoarthritis but is less effective than NSAIDs

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Q Is paracetamol efficacious for treatment of osteoarthritis (OA)?


Embedded ImageData sources:

Medline, CINAHL, EMBASE/Excerpta Medica, Scientific Citation Index, and Cochrane Library (up to July 2003); reference lists; and conference abstracts from international societies of rheumatology (previous 2 y).

Embedded ImageStudy selection and assessment:

randomised controlled trials (RCTs) that compared paracetamol with placebo or non-steroidal anti-inflammatory drugs (NSAIDs) in patients who had radiographic evidence of OA or met American College of Rheumatology clinical criteria for OA or had pain associated with OA. Quality of individual studies was assessed based on randomisation, blinding, and withdrawals.

Embedded ImageOutcomes:

pain reduction from baseline, change in total Western Ontario and McMaster University (WOMAC) OA Index scores, change in function and stiffness, and adverse events (gastrointestinal discomfort, nausea, headache, and dizziness).


10 trials (n = 2144) met the selection criteria. …

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  • For correspondence: Dr W Zhang, University of Nottingham, City Hospital, Nottingham, UK.

  • Source of funding: Arthritis Research Campaign.