for the main comparison.
| Non‐steroidal anti‐inflammatory agents (NSAIDs) compared with placebo for CIN 2 or CIN 3 | ||||||
|
Patient or population: women with CIN 2 or CIN 3 Settings: outpatient Intervention: celecoxib 400 mg by mouth daily for 14‐18 weeks, 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) | Certainty of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Progression of CIN to a higher grade of CIN | 77 per 10001 | 42 per 1000 | RR 0.54 (0.06 to 5.24) | 25 (one study) | ⊕⊝⊝⊝3 very low | |
| Partial or complete regression of CIN 2 or CIN 3 | 308 per 10002 | 447 per 1000 | RR 1.45 (0.93 to 2.27) | 132 (three studies) | ⊕⊕⊕⊝3 moderate | |
| Complete regression of CIN 2 or CIN 3 | 174 per 10001 | 228 per 1000 | RR 1.31 (0.65 to 2.67) | 116 (two studies) | ⊕⊕⊕⊝3 moderate | |
| *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 certainty: Further research is very unlikely to change our confidence in the estimate of effect. Moderate certainty: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low certainty: 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 certainty: We are very uncertain about the estimate. | ||||||
1The basis for the assumed risk is from the spontaneous complete regression rate in the placebo arm of Farley 2006 and Rader 2017
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; Rader 2017
3Given the increased sample size with the addition of Rader 2017, we have upgraded the certainty to high other than the Progression analysis as it is based on one small study and thus remained very low certainty.