Non-steroidal anti-inflammatory drugs (NSAIDs) for treating acute ankle sprains in adults: benefits outweigh adverse events

Bekerom, Michel P.J. van den; Sjer, Arnout; Somford, Matthijs P.; Bulstra, Gythe H.; Struijs, Peter; Kerkhoffs, Gino M. M. J.

doi:10.1007/s00167-014-2851-6

Cited by 41 publications

(24 citation statements)

References 34 publications

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“…In contrast to other reviews,3 the current review does not show a beneficial effect of using NSAIDs. The majority of the collected evidence was either low quality, meaning further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate, or very low quality, meaning we are very uncertain about the estimate.…”

Section: Commentarycontrasting

confidence: 99%

No difference in pain, swelling or function with NSAIDs compared with paracetamol for soft tissue injury

Bekerom

2015

Evid Based Nurs

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Section: Commentarycontrasting

confidence: 99%

No difference in pain, swelling or function with NSAIDs compared with paracetamol for soft tissue injury

Bekerom

2015

Evid Based Nurs

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“…Furthermore, the time scale of NSAID administration warrants further investigation. While some studies have shown beneficial effects of NSAIDs for musculoskeletal injuries when administered acutely to manage the symptomatology of inflammation 71,72 , others have shown no effects or inhibitory effects over similar time scales 73,74 . Given the confounding nature of these results, future studies are needed to evaluate the effects of the duration of NSAID administration on ECM scaffold mediated constructive remodeling.…”

Section: Discussionmentioning

confidence: 99%

Inhibition of COX1/2 alters the host response and reduces ECM scaffold mediated constructive tissue remodeling in a rodent model of skeletal muscle injury

et al. 2016

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Extracellular matrix (ECM) has been used as a biologic scaffold material to both reinforce the surgical repair of soft tissue and serve as an inductive template to promote a constructive tissue remodeling response. Success of such an approach is dependent on macrophage-mediated degradation and remodeling of the biologic scaffold. Macrophage phenotype during these processes is a predictive factor of the eventual remodeling outcome. ECM scaffolds have been shown to promote an anti-inflammatory or M2-like macrophage phenotype in vitro that includes secretion of downstream products of cycolooxygenases 1 and 2 (COX1/2). The present study investigated the effect of a common COX1/2 inhibitor (Aspirin) on macrophage phenotype and tissue remodeling in a rodent model of ECM scaffold treated skeletal muscle injury. Inhibition of COX1/2 reduced the constructive remodeling response by hindering myogenesis and collagen deposition in the defect area. The inhibited response was correlated with a reduction in M2-like macrophages in the defect area. The effects of Aspirin on macrophage phenotype were corroborated using an established in vitro macrophage model which showed a reduction in both ECM induced prostaglandin secretion and expression of a marker of M2-like macrophages (CD206). These results raise questions regarding the common peri-surgical administration of COX1/2 inhibitors when biologic scaffold materials are used to facilitate muscle repair/regeneration.

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“…Although in some cases it has been shown that topical formulations can reach higher concentrations in the inflamed tissues than the oral ones [10]. Likewise, topical application may limit systemic adverse effects by increasing local effects and minimizing systemic drug concentrations [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Celecoxib 2% Cream in Acute Soft Tissue Injuries: Randomized, Double-blind, Placebo-controlled Clinical Trial

Geannyne¹,

Amador²,

Silvia³

et al. 2017

Clin Res Foot Ankle

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Objective: The aim of the study was to evaluate the efficacy of pain reduction and tolerability of topical administration of Celecoxib 2% cream compared to Celecoxib 1% cream and placebo cream in Mexican patients who had acute soft tissue injury in lower limbs. Methods:A randomized, double-blind, placebo control trial with 3 parallel groups was conducted. We include Mexicans patients older than 18 years with diagnosis of acute soft tissue injury in lower limbs. They were randomly assigned to Celecoxib 2% cream (CEL-2), Celecoxib 1% cream (CEL-1) or placebo cream (PLA). All treatments should be applied 3 times a day for a period of 7 days. Every day the pain was assessed with a Visual Analogue Scale (VAS). Secondary, we evaluate inflammation and adverse events.Results: A total of 95 patients were included. VAS on day 1 and 7 in group CEL-2 were 57.41 ± 10.39 mm and 4.34 ± 7.02 mm, in CEL-1 59.38 ± 9.37 mm and 10.41 ± 12.78 mm, and in PLA 55.61 ± 8.09 mm and 9.32 ± 9.93 mm. CEL-2 showed greater pain decrease compared to CEL-1 and PLA, p<0.05. CEL-1 group significantly decreased inflammation more than PLA, p<0.05. 15 adverse events were reported in 9 patients, none was severe. Conclusion:The results shown in the present study demonstrate that topical administration of Celecoxib cream 2%, TID for 7 days was effective in pain relief in patients with acute soft tissue injury.

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Non-steroidal anti-inflammatory drugs (NSAIDs) for treating acute ankle sprains in adults: benefits outweigh adverse events

Abstract: Meta-analysis of RCTs, Level I.

Cited by 41 publications

References 34 publications

No difference in pain, swelling or function with NSAIDs compared with paracetamol for soft tissue injury

No difference in pain, swelling or function with NSAIDs compared with paracetamol for soft tissue injury

Inhibition of COX1/2 alters the host response and reduces ECM scaffold mediated constructive tissue remodeling in a rodent model of skeletal muscle injury

Celecoxib 2% Cream in Acute Soft Tissue Injuries: Randomized, Double-blind, Placebo-controlled Clinical Trial

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