Table 1.

Use of non-steroidal anti-inflammatory drugs

Statement	Category of evidence
NSAIDs are effective drugs in relieving pain and immobility associated with osteoarthritis. COX-2 selective agents are equally effective.	A*
NSAIDs and COX-2 inhibitors vary in their potential gastrointestinal, liver and cardio-renal toxicity. This risk varies between individual treatments within both groups and is increased with dose and duration of treatment	A*
COX-2 selective agents are associated with a significantly lower gastrointestinal toxicity (PUBs and dyspepsia) compared to non-selective NSAIDs. Co-prescribing of aspirin reduces this advantage.	A*
PPI should always be considered with a non-selective NSAID and with a COX-2 agent in higher GI risk patients.	C†

*A-Directly based on evidence from a meta-analysis of randomised controlled trials or from at least one randomised controlled trials

†C Directly based on evidence from non-experimental descriptive studies, such as comparative studies, correlation studies and case control studies or extrapolated from meta-analysis of randomised controlled trials, or extrapolated from at least one randomised controlled trial.