Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2024; 12(12): 2056-2064
Published online Apr 26, 2024. doi: 10.12998/wjcc.v12.i12.2056
Systematic review and network meta-analysis of different non-steroidal anti-inflammatory drugs for juvenile idiopathic arthritis
Tao Zeng, Jian-Zhong Ye, Hui Qin, Qian-Qian Xu
Tao Zeng, Jian-Zhong Ye, Hui Qin, Qian-Qian Xu, College of Medicine, Jingchu University of Technology Jingmen, Jingmen 448000, Hubei Province, China
Author contributions: Zeng T and Ye JZ conceived and designed the study; Qin H searched and selected relevant studies; Xu QQ and Zeng T extracted and interpreted data; and all authors critically reviewed and approved the final manuscript.
Supported by the Science and Technology Plan Project of Jingmen Science and Technology Bureau, No. 2018YFZD025.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Qian-Qian Xu, MD, Senior Statistician, College of Medicine, Jingchu University of Technology Jingmen, No. 33 Xiangshan Road, Jingmen 448000, Hubei Province, China.
Received: September 22, 2023
Peer-review started: September 22, 2023
First decision: December 15, 2023
Revised: January 23, 2024
Accepted: March 1, 2024
Article in press: March 1, 2024
Published online: April 26, 2024
Research background

Different non-steroidal anti-inflammatory drugs (NSAIDs) have been used for juvenile idiopathic arthritis (JIA), but the best method has not been determined.

Research motivation

To perform a systematic review and network meta-analysis to identify the most effective NSAID for JIA patients.

Research objectives

To perform a systematic review and network meta-analysis to determine the optimal instructions.

Research methods

We searched for randomized controlled trials (RCTs) from PubMed, EMBASE, Google Scholar, CNKI, and Wanfang without restriction for publication date or language at August, 2022. Any RCTs that comparing the effectiveness of NSAIDs with each other or placebo for JIA were included in this network meta-analysis. The surface under the cumulative ranking curve (SUCRA) analysis was used to rank the treatments. P value less than 0.05 was identified as statistically significant.

Research results

Eight RCTs (1127 patients) compared different instructions for NSAIDs, including meloxicam, Celecoxib, piroxicam, Naproxen, inuprofen, Aspirin, Tolmetin, Rofecoxib, and placebo. No significant differences were found in ACR Pedi 30 response between any two NSAIDs. Celecoxib (6 mg/kg bid) had the highest SUCRA ranking at 88.9%, followed by rofecoxib at 68.1% and Celecoxib (3 mg/kg bid) at 51.0%. There were no notable differences in adverse events between NSAIDs. Placebo had the highest ranking, followed by piroxicam, rofecoxib (0.600 mg/kg qd), meloxicam (0.125 mg/kg qd), and rofecoxib (0.300 mg/kg qd).

Research conclusions

In summary, celecoxib (6 mg/kg bid) was found to be the most effective NSAID for treating JIA.

Research perspectives

Rofecoxib, piroxicam, and meloxicam may be safer options, but further research is needed to confirm these findings in larger trials with higher quality studies.