Summary of findings for the main comparison.
| Non‐steroidal anti‐inflammatory agents (NSAIDs) compared with placebo for CIN 2 or CIN 3 | ||||||
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Patient or population: women with CIN 2 or CIN 3 Settings: outpatient Intervention: celecoxib 200 mg by mouth, twice daily for six months or rofecoxib 40 mg by mouth, daily for three months Comparison: placebo tablet by mouth, daily for three to six months | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No. of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Complete regression of CIN 2 or CIN 3 | 154 per 1000¹ | 333 per 1000 | RR 2.17 (0.48 to 9.76) | 25 (one study) | ⊕⊝⊝⊝ very low | |
| Partial or complete regression of CIN 2 or CIN 3 | 238 per 100² | 550 per 1000 | RR 2.35 (1.03 to 5.35) | 41 (two studies) | ⊕⊝⊝⊝ very low | |
| Progression of CIN to a higher grade of CIN | 167 per 1000¹ | 77 per 1000 | RR 0.54 (0.06 to 5.24) | 25 (one study) | ⊕⊝⊝⊝ very low | |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; CIN: cervical intraepithelial neoplasia; RR: risk ratio | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
¹ The basis for the assumed risk is from the spontaneous complete regression rate in the placebo arm of Farley 2006
² The basis for the assumed risk is from the combined spontaneous partial or complete regression rates in the placebo arms of Farley 2006; Hefler 2006
Given the paucity of data in the included studies, the small sample size, and the limitations from early study closure, we have downgraded the quality of the evidence to very low quality.