On Thu, 10 Sep 1998 02:39:11 +0100, Katie Law wrote:
>I hear it on good authority that paracetamol and Ibuprofen are really as
>good as each other, and paracetamol being safer .......
A gp-uk first: Risk writes on Evidence:
Source: RCP: Report of the joint working group of the Brit Soc of Rheum
and the Research Unit of the RCP
Title: Guidelines: diagnosis and management of OA of the hip and knee
Quotes:
"Analgesics remain the first choice in drug therapy. The initial
choice should be Paracetamol 0.5-1gm 4-6 hourly, max.4g/day"
"NSAIDs are widely used. Their superiority over simple analgesics is
poorly documented. For example, a recent study* showed no benefit over
paracetamol for low (analgesic) or high (anti-inflammatory) doses of
Ibuprofen. Although inflammation may be a feature of OA, there is
little evidence that NSAIDs are acting other than analgesics"
"... there are no convincing data to favour some NSAIDs more than
others for use in OA. Major differences in the safety profiles of
different NSAIDs have yet to be established" (!)
"... evidence that NSAIDs affect the OA process in man is still being
sought" [this is referring to possible beneficial or detrimental
effects on cartilage](AR)
Comment: the guideline also mentions that the more serious seide
effects of NSAIDs are more common and more serious in elderly women,
precisely the population most in need of symptomatic control!
* [Bradley JD, Brandt KD, Katz BP, et al. Comparison of an
anti-inflammatory dose of ibuprofen, an analgesic dose of ibuprofen and
acetaminophen in the treatment of patients with osteoarthritis of the
knee. N Engl J Med 1991;325:87-91
Ahmad
________________________________________
Dr Ahmad Risk
http://mednetics.org
home: +44 1273 748198
work: +44 1737 240022
fax: +44 1737 244660
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|