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. 2017 Aug 2;2017(8):CD012537. doi: 10.1002/14651858.CD012537.pub2
Study Treatment Pain outcome Other efficacy outcomes
Bhettay 1978 Intervention group (N = 15): indomethacin (2 weeks) then cross‐over to ketoprofen (2 weeks)
Control group (N = 15): ketoprofen (2 weeks) then cross‐over to indomethacin (2 weeks)
Participants < 20 kg: ketoprofen 25 mg capsule twice daily; participants > 20 kg: ketoprofen capsules x 2 = 50 mg twice daily
Participants < 20 kg: indomethacin 25 mg capsule twice daily; participants > 20 kg: indomethacin capsules x 2 = 50 mg twice daily
Study duration: 5 weeks
Participant‐reported pain relief of 30% or greater:
no data
Participant‐reported pain relief of 50% or greater:
no data
PGIC much or very much improved:
no data
Patient Global Impression of Change:
no data
Carer Global Impression of Change:
no data
Requirement for rescue analgesia:
no data
Sleep duration and quality:
no data
Acceptability of treatment:
no data
Physical functioning:
no data
Quality of life:
no data
Brewer 1982 Intervention group (N = 50): fenoprofen 900 mg/m2/d increased to 1800 mg/m2/d, maximum 3200 mg/d
Control group (N = 49): aspirin 1500 mg/m2/d increased to 3000 mg/m2/d, maximum 5450 mg/d
Study duration: 12 weeks
Participant‐reported pain relief of 30% or greater:
≥ 25% improvement
Severity of pain on movement
fenoprofen: 23/50
aspirin: 21/49
Severity of limitation of movement
fenoprofen: 18/50
aspirin: 16/49
Participant‐reported pain relief of 50% or greater:
≥ 50% improvement
Severity of pain on movement
fenoprofen: 18/50
aspirin: 15/49
Severity of limitation of movement
fenoprofen: 12/50
aspirin: 12/49
PGIC much or very much improved: no data
Patient Global Impression of Change:
Patient global assessment of patient response (satisfactory) to therapy
fenoprofen: 30/50
aspirin: 24/49
Carer Global Impression of Change:
Parent global assessment of patient response (satisfactory) to therapy
fenoprofen: 34/50
aspirin: 30/49
Physician global assessment of patient response
fenoprofen: 31/50
aspirin: 31/49
Requirement for rescue analgesia: no data
Sleep duration and quality: no data
Acceptability of treatment: no data
Physical functioning: no data
Quality of life: no data
Foeldvari 2009 Intervention group (N = 77): celecoxib 50 mg/5 mL oral suspension (target dose approximately 3 mg/kg twice daily)
Intervention group (N = 82): celecoxib 100 mg/5 mL oral suspension (target dose approximately 6 mg/kg twice daily)
Control group (N = 83): naproxen 125 mg/5 mL oral suspension (target dose approximately 7.5 mg/kg twice daily)
Study duration: 12 weeks
Participant‐reported pain relief of 30% or greater:
ACR Pediatric‐30 responders, n (%)
celecoxib 3 mg/kg: 53/77 (68.8%)
celecoxib 6 mg/kg: 66/82 (80.5%)
naproxen 7.5 mg/kg: 56/83 (67.5%)
Participant‐reported pain relief of 50% or greater: no data
PGIC much or very much improved: no data
Patient Global Impression of Change: no data
Carer Global Impression of Change:
Parent global assessment of overall well‐being 100‐millimetre VAS, least squares mean change from baseline (SE)
celecoxib 3 mg/kg: ‐17.96 (2.42)
celecoxib 6 mg/kg: ‐20.45 (2.34)
naproxen 7.5 mg/kg: ‐18.25 (2.33)
Physician global assessment of disease activity:
100‐millimetre VAS, least squares mean change from baseline (SE)
celecoxib 3 mg/kg: ‐21.07 (1.86)
celecoxib 6 mg/kg: ‐23.27 (1.80)
naproxen 7.5 mg/kg: ‐21.88 (1.79)
Requirement for rescue analgesia: no data
Sleep duration and quality: no data
Acceptability of treatment: no data
Physical functioning:
Parent assessment of physical functioning, Child Health Assessment Questionnaire, disability index 0 to 3, least squares mean change from baseline (SE)
celecoxib 3 mg/kg: ‐0.28 (0.05)
celecoxib 6 mg/kg: ‐0.32 (0.05)
naproxen 7.5 mg/kg: ‐0.31 (0.05)
Quality of life: Pediatric Quality of Life Inventory
All treatment groups improved Pediatric Quality of Life Inventory scores. Scores of participants in the celecoxib 6 mg/kg twice‐daily group or naproxen 7.5 mg/kg twice‐daily group were higher than those of participants in the celecoxib 3 mg/kg twice‐daily group, but results were non‐significant (data not shown in publication). Unclear whether differences are between groups or over time.
celecoxib 3 mg/kg: no data
celecoxib 6 mg/kg: no data
naproxen 7.5 mg/kg: no data
Giannini 1990 Intervention group (N = 45): ibuprofen suspension (concentration 100 mg/5mL) + placebo aspirin
Control group (N = 47): aspirin 200 mg tablet (participant weight 10 to 30 kg) or 300 mg capsules (participant weight > 30 kg) + placebo ibuprofen
Week 2: physician's option to increase dose to 40 mg/kg/day ibuprofen or 80 mg/kg/day aspirin, provided no significant side effects
Study duration: 12 weeks
Participant‐reported pain relief of 30% or greater: no data
Participant‐reported pain relief of 50% or greater: no data
PGIC much or very much improved:
Patient Global Impression of Change very much improved:
ibuprofen: 22/26 (85%)
aspirin: 18/20 (90%)
Carer Global Impression of Change:
ibuprofen: 33/42 (79%)
aspirin: 29/35 (83%)
Investigator Global Evaluation:
ibuprofen: 34/44 (78%)
aspirin: 27/35 (77%)
Patient Global Impression of Change:
ibuprofen: 22/26 (85%)
aspirin: 18/20 (90%)
Carer Global Impression of Change:
ibuprofen: 33/42 (79%)
aspirin: 29/35 (83%)
Investigator Global Evaluation:
ibuprofen: 34/44 (78%)
aspirin: 27/35 (77%)
Requirement for rescue analgesia: no data
Sleep duration and quality: no data
Acceptability of treatment: no data
Physical functioning: no data
Quality of life: no data
Moran 1979 Intervention group (N = 23): naproxen 10 mg/kg/24 hrs given as a suspension in 2 divided doses
Control group (N = 23): aspirin soluble 80 mg/kg/day, divided into 4 doses
Study duration: 2 x 4 weeks
Participant‐reported pain relief of 30% or greater: no data
Participant‐reported pain relief of 50% or greater: no data
PGIC much or very much improved: no data
Patient Global Impression of Change: no data
Carer Global Impression of Change: no data
Requirement for rescue analgesia: no data
Sleep duration and quality: no data
Acceptability of treatment:
Medication preference at end of trial:
Naproxen much better: 0
Naproxen better: 9
Both periods equal: 9
Aspirin better: 4
Aspirin much better: 1
Physical functioning: no separate data
Quality of life: no data
Reiff 2006 Intervention group (N = 209): (children) LD rofecoxib 0.3mg/kg/day maximum 12.5mg/day, or HD rofecoxib 0.6mg/kg/day maximum 25 mg/day; (adolescents) rofecoxib 12.5 or 25 mg daily
Control group (N = 101): (children) naproxen 15 mg/kg/day 5 mg oral suspension; (adolescents) 15 mg/kg/day maximum 1000 mg/day
Study duration: 12 weeks
Participant‐reported pain relief of 30% or greater:
ACR Pedi 30% reduction
LD rofecoxib: 45/97 (46.2%)
HD rofecoxib: 49/90 (54.5%)
naproxen: 48/87 (55.1%)
Participant‐reported pain relief of 50% or greater: no data
PGIC much or very much improved: no data
Patient Global Impression of Change: no data
Carer Global Impression of Change: no data
Patient/Parent Global Assessment of Pain:
mean change from baseline (95% CI)
LD rofecoxib: ‐12.50 (‐15.98; ‐9.02)
HD rofecoxib: ‐13.12 (‐16.75; ‐9.48)
naproxen: ‐8.43 (‐11.98; ‐4.88)
Requirement for rescue analgesia: no data
Sleep duration and quality: no data
Acceptability of treatment: no data
Physical functioning:
CHAQ index: mean change from baseline (95% CI)
LD rofecoxib: ‐0.11 (‐0.18; ‐0.05)
HD rofecoxib: ‐0.15 (‐0.21; ‐0.08)
naproxen: ‐0.12 (‐0.18; ‐0.05)
Quality of life:
Patient/parent assessment of overall well‐being:mean change from baseline (95% CI) (proportion of improvement from baseline)
LD rofecoxib: ‐11.57 (‐14.78; ‐8.36) (74.3%)
HD rofecoxib: ‐12.08 (‐15.44; ‐8.73) (76%)
naproxen: ‐8.56 (‐11.85; ‐5.27) (73%)
Additional data
Investigators' global assessment of disease activity: mean change from baseline (95% CI)
LD rofecoxib: ‐12.45 (‐14.95; ‐9.94)
HD rofecoxib: ‐13.27 (‐15.88; ‐10.65)
naproxen: ‐12.05 (‐14.60; ‐9.50)
Ruperto 2005 Intervention group 1 (N = 73): LD meloxicam 0.125 mg/kg, 1 dose per day
Intervention group 2 (N = 74): HD meloxicam 0.25 mg/kg, 1 dose per day
Control group (N = 78): naproxen 5 mg/kg, twice per day
Study duration: 48 weeks
Participant‐reported pain relief of 30% or greater:
@ 3 MONTHS
LD meloxicam: 46/73 (63%), 95% CI 52 to 74%
HD meloxicam: 43/74 (58%), 95% CI 47 to 69%
naproxen: 50/78 (64%), 95% CI 53 to 75%
@ 12 MONTHS
LD meloxicam: 56/73 (77%), 95% CI 67 to 86%
HD meloxicam: 56/74 (76%), 95% CI 66 to 85%
naproxen: 58/78 (74%), 95% CI 65 to 84%
Participant‐reported pain relief of 50% or greater:
@ 3 MONTHS
LD meloxicam: 38/73 (52%), 95% CI 41 to 64%
HD meloxicam: 32/74 (43%), 95% CI 32 to 55%
naproxen: 39/78 (50%), 95% CI 39 to 61%
@ 12 MONTHS
LD meloxicam: 50/73 (68%), 95% CI 58 to 79%
HD meloxicam: 48/74 (65%), 95% CI 54 to 76%
naproxen: 53/78 (68%), 95% CI 58 to 78%
TOTAL POOLING: P = 0.7
PGIC much or very much improved: no data
Patient Global Impression of Change: no data
Participant reported assessment of discomfort (facial affective scale 1 to 9 points):
@ 3 MONTHS
LD meloxicam: 0.3 ± 0.2
HD meloxicam: 0.4 ± 0.2
naproxen: 0.3 ± 0.2
@ 12 MONTHS
LD meloxicam: 0.3 ± 0.2
HD meloxicam: 0.3 ± 0.2
naproxen: 0.2 ± 0.2
Physician global impression of disease activity (VAS 0 to 100):
@ 3 MONTHS
LD meloxicam: 19.4 ± 20.7
HD meloxicam: 20.6 ± 20.3
naproxen: 21.1 ± 19.2
@ 12 MONTHS
LD meloxicam: 15.4 ± 20.5
HD meloxicam: 16.8 ± 19.0
naproxen: 14.4 ± 16.7
Carer Global Impression of Pain (VAS 0 to 100):
@ 3 MONTHS
LD meloxicam: 17.6 ± 20.2
HD meloxicam: 21.9 ± 23.6
naproxen: 20.8 ± 22.4
@ 12 MONTHS
LD meloxicam: 13.4 ± 17.6
HD meloxicam: 17.2 ± 22.5
naproxen: 15.9 ± 21.3
Requirement for rescue analgesia: no data
Sleep duration and quality: no data
Acceptability of treatment: no data
Physical functioning:
CHAQ Disability Index (0 to 3 points)
@ 3 MONTHS
LD meloxicam: 0.4 ± 0.5
HD meloxicam: 0.5 ± 0.6
naproxen: 0.5 ± 0.6
@ 12 MONTHS
LD meloxicam: 0.3 ± 0.4
HD meloxicam: 0.4 ± 0.6
naproxen: 0.3 ± 0.5
Quality of life: no data
ACR: American College of Rheumatology; CI: confidence interval; HD: high‐dose; LD: low‐dose; N: number of participants; PGIC: Patient Global Impression of Change;SE: standard error; VAS: visual analogue scale