Identifying predictors of response for oral non-steroidal anti-inflammatory drugs and paracetamol in osteoarthritis


In randomised controlled trials (RCTs) symptomatic treatments for osteoarthritis (OA) provide only a small-to-moderate efficacy to date. Treatment guidelines have therefore emphasised the need to identify predictors of treatment response through subgroup and multiple regression analysis. Individual patient data (IPD) meta-analysis is recommended as an efficient approach for this purpose. To the best of our knowledge, this has not been undertaken for oral non-steroidal anti-inflammatory drugs (NSAIDs), including paracetamol, in OA.


IPD will be retrieved from RCTs of oral NSAIDs or paracetamol in OA. Multilevel regression models will be established to identify predictors for the specific (active – placebo) and the overall treatment effect (change from baseline in active group). IPD network meta-analysis will be used to explore placebo effect (placebo – no treatment) and relative effect between NSAIDs and paracetamol and their predictors.


Data collection in process.

Protocol and publications


W. (Weiya) Zhang 3, 4
Y. (Yilin) Xiong 1
C. (Chao) Zeng 1, 2
M. (Michael) Doherty 3, 4
M. (Monica) S.M. Persson 3, 4
J. (Jie) Wei 2, 5
M. (Marienke) van Middelkoop 6
G. (Guanghua) Lei 1, 7, 8, 9

1. Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
2. Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
3. Academic Rheumatology, Clinical Sciences Building, University of Nottingham, City Hospital, Nottingham, UK
4. Pain Centre Versus Arthritis UK, Nottingham, UK
5. Health Management Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
6. Department of General Practice, Erasmus MC Medical University, Rotterdam, The Netherlands
7. Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, Hunan, China
8. Hunan Engineering Research Center of Osteoarthritis, Changsha, Hunan, China
9. National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.