Dose-response in Direct Comparisons of Different Doses of Aspirin, Ibuprofen and Paracetamol (acetaminophen) in Analgesic Studies

Overview

Journal Br J Clin Pharmacol

Specialty Pharmacology

Date 2006 Jul 28

PMID 16869819

Citations 31

Authors

Henry J McQuay

R Andrew Moore

Affiliations

Soon will be listed here.

Abstract

Aims: Establishing the dose-response relationship for clinically useful doses of aspirin, ibuprofen and paracetamol has been difficult. Indirect comparison from meta-analysis is compromised by too little information at some doses.

Methods: A systematic review of randomized, double-blind trials in acute pain comparing different doses of aspirin, ibuprofen and paracetamol was therefore undertaken.

Results: Fifty trials were found. Numerical superiority of higher over lower dose was found by the original authors in 37/50 trials (74%) and statistical superiority in 11/50 (22%). Twenty-eight trials had design, quality and data reporting characteristics to allow pooling of common doses; in 3/28 (11%) of the individual trials our calculations showed statistical superiority of higher over lower dose. Pooled comparison of 1000/1200 mg aspirin over 500/600 mg was statistically superior, with a number-needed-to-treat (NNT) for higher over lower dose of 16 (8 to > 100). Pooled comparison of 400 mg ibuprofen over 200 mg was statistically superior, with an NNT for higher over lower dose of 10 (6-23). Pooled comparison of 1000 mg paracetamol over 500 mg was statistically superior, with an NNT for higher over lower dose of 9 (6-20).

Conclusions: Use of trials making direct comparison of two different doses of target drugs revealed the underlying dose-response curve for clinical analgesia.

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