The research study included data from 181 publications describing 192 clinical trials involving a total of over 100,000 patients.
The researchers found that the NSAID etoricoxib (60 mg/day) and the NSAID diclofenac (150 mg/day) were the most effective anti-inflammatory drugs for osteoarthritis compared to placebo. However, the drugs were associated with an increased risk of side effects, especially in patients with comorbidities or when used for long periods of time. Most other NSAIDs provided similar pain relief and were associated with similar side effects and were therefore also considered good drug alternatives for osteoarthritis pain relief.
What should be remembered is that oral NSAIDs should only be taken when needed and are not suitable for long term use.
Topical NSAIDs (ointments, creams, or gels) were less associated with a risk of side effects but remained effective. It was thereby concluded that topical NSAIDs should be considered a first-line treatment for knee osteoarthritis related pain.
Opioids were not recommended as their analgesic effect did not outweigh their risks (several side effects and the high risk of developing an addiction).
Paracetamol (4000 mg/day) had a very low effect on osteoarthritis pain and was therefore considered a lot less effective than oral or topical NSAIDs.
The article is published in the highly regarded British Medical Journal (BMJ).
Read the whole study here.