Abstract
ObjectivesTo analyze the safety of combining non-steroidal anti-inflammatory drugs (NSAID) and steroids. MethodsA systematic review following a sensitive search strategy was performed. All articles published in MEDLINE (since 1961), EMBASE (since 1961), and Cochrane Library, up to December 2007 were examined. Selection criteria: the population (subjects with musculoskeletal diseases on steroids), the intervention (concomitant use of NSAID), and outcomes related to drugs safety (gastrointestinal, renal, and cardiovascular toxicity). Titles and abstracts of retrieved articles meeting inclusion criteria from the search were reviewed. Only randomized controlled trials (RCT) or high quality cohort studies with a control group were included. ResultsOf a total of 4164 references retrieved, 42 were analyzed in detail, and 10 were finally included, 6 RCT and 4 prospective cohort studies, which included more than 20 000 patients. ConclusionsThe use of NSAID and low dose of steroids in patients with musculoskeletal diseases does not seem to increase the risk of gastrointestinal adverse events.
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