Herrmann 2009.

Methods	Prospective, double‐blind, randomised, multicentre, placebo‐ and active‐controlled, parallel‐group trial
Participants	171 outpatients (men 44%, women 56%), aged 18 to 70 years. Inclusion criteria: acute sciatica/lumbago‐sciatica with onset < 72 hrs; pain < 70 (VAS); previous episode > 3 months; pain radiating along the sciatic nerve (include below the knee); worsening with straight leg raise test (< 60 degrees). Lumbo‐sciatica defined as sciatica associated with paravertebral pain (superior spina iliaca and gluteal fold). Exclusion criteria: neurological symptoms of herniated disc (paraesthesia; muscular weakness; paralysis); cauda equina syndrome; ankylosing spondylitis; rheumatoid arthritis; significant disease, alcohol abuse; history of hospitalisation or bed rest; physiotherapy; hypersensitive of NSAIDs; use of other NSAIDs during last week; use of corticosteroids within 4 weeks; no narcotic analgesics within 12 hrs; anxiolytics, antidepressants and/or muscle relaxants, topical treatment with NSAIDs, anticoagulants, immunosuppressants; known adverse drug reaction to oxicam
Interventions	Treatment duration: 5 days, follow‐up duration/time of measurement: 3 and 8 hours, 2 and 3 days. (i) NSAID group 1: lornoxicam (LNX) day 1, 8 mg TID; day 2 to 4, 8 mg BID; day 5, 8 mg OD (ii) NSAID group 2: diclofenac day 1 and 5, 50 mg BID; day 2 to 4, 50 mg TID (iii) Placebo administrated as LNX
Outcomes	Pain: Pain reduction (VAS 0 to 100) significantly higher for LNX vs placebo from 3 to 8 hrs. No significant differences were seen for days 2 and 3 between the groups, no values for pain reduction reported. Disability: Not assessed. Global improvement: Overall efficacy rated as very good or good by the participants at day 2 to 4: 65% in the lornoxicam group, 72% in the diclofenac group, 56% in the placebo group. Additional drug use: Addditional analgesics were not permitted during study. Other outcomes: Not assessed Adverse effects: Mild to moderate adverse symptoms were reported by (i) n = 6; (ii) n = 7; (iii) n = 4. 2 participants reported severe nausea, abdominal pain, and dyspepsia
Notes	Withdrawal: 7 participants (4%) withdrew: due to early success (n = 1); due to insufficient efficacy (n = 3); result of adverse events (n = 3). Adherence: On day 5 47% of participants took capsules: (i) n = 20; (ii) n = 27; (iii) n = 33. Funding was reported. Nycomed Pharma Austria supplied the medication, and at least 1 author was employed at Nycomed Pharma
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Randomly assigned to treatment groups in blocks
Allocation concealment (selection bias)	Low risk	Randomisation performed centrally
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Placebo capsules were added to the LNX and diclofenac blister packs provided by the investigator to ensure blinding and correct dosage
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Randomisation was concealed until trial was completed
Incomplete outcome data (attrition bias) All outcomes	Low risk	Intention to treat (LOCF)
Selective reporting (reporting bias)	Unclear risk	Reported all prespecified outcomes; no protocol
Group similarity at baseline	Low risk	Similar baseline characteristics
Influence of co‐interventions	Low risk	No rescue medication allowed, short follow‐up duration (5 days)
Compliance with interventions	Unclear risk	Yes, 6 participants discontinued treatment in the placebo group due to insufficient efficacy, and 1 discontinued treatment in the diclofenac group due to side effects
Funding	High risk	Nycomed Pharma Austria supplied the medication, and at least 1 author was employed at Nycomed Pharma
Other bias	Low risk	Medium‐size trial. Well presented