Summary of findings for the main comparison. NSAID compared with placebo for fibromyalgia.
| NSAID compared with placebo for fibromyalgia | ||||||
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Patient or population: adults with fibromyalgia Settings: community Intervention: any NSAID Comparison: placebo | ||||||
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Outcomes (at trial end) |
Probable outcome with NSAID | Probable outcome with placebo | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments |
| Substantial pain relief: at least 50% reduction in pain, or PGIC much improved |
110 per 1000 | 180 per 1000 | RD ‐0.07 (95% CI ‐0.18 to 0.04) | 2 studies 146 participants 21 events |
Very low quality | Downgraded three levels due to small number of studies, participants, and events |
| Moderate pain relief: at least 30% reduction in pain, or PGIC much or very much improved |
220 per 1000 | 260 per 1000 | RD ‐0.04 (95% CI ‐0.16 to 0.08) | 3 studies 192 participants 46 events |
Very low quality | Downgraded three levels due to small number of studies, participants, and events |
| Serious adverse events | None reported | None reported | Not calculated | No data | Very low quality | No events |
| Adverse event withdrawal | 50 per 1000 | 20 per 1000 | RD 0.04 (95% CI ‐0.02 to 0.09) | 4 studies 230 participants 8 events |
Very low quality | Downgraded three levels due to small number of studies, participants, and events |
| Participants experiencing any adverse event | 310 per 1000 | 220 per 1000 | RD 0.08 (95% CI ‐0.03 to 0.19) | 4 studies 230 participants 61 events |
Very low quality | Downgraded three levels due to small number of studies, participants, and events |
| All cause withdrawal | 230 per 1000 | 200 per 1000 | RD 0.03 (‐0.07 to 0.14) | 3 studies 192 participants 41 events |
Very low quality | Downgraded three levels due to small number of studies, participants, and events |
| Death | No data | No data | Not calculated | No data | Very low quality | No events |
| CI: Confidence interval; PGIC: Patient Global Impression of Change; RD: Risk difference | ||||||
| Descriptors for levels of evidence (EPOC 2015):
High quality: this research provides a very good indication of the likely effect. The likelihood that the effect will be substantially differenta is low.
Moderate quality: this research provides a good indication of the likely effect. The likelihood that the effect will be substantially differenta is moderate.
Low quality: this research provides some indication of the likely effect. However, the likelihood that it will be substantially differenta is high.
Very low quality: this research does not provide a reliable indication of the likely effect. The likelihood that the effect will be substantially differenta is very high. aSubstantially different: a large enough difference that it might affect a decision. | ||||||