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Anti-inflammatory drugs and analgesics for managing symptoms in people with cystic fibrosis-related arthritisThornton J, Rangaraj S
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SummaryThe use of drugs to manage symptoms in people with arthritis related to cystic fibrosisArthritis is not a common complication of cystic fibrosis, but it can be a major complication when it does occur. There are two distinct types of arthritis in cystic fibrosis: cystic fibrosis-related arthropathy (CFA) and hypertrophic pulmonary osteoarthropathy (HPO). The best treatment for these conditions is not clear because of the underlying disease and its intense treatment. We planned to report evidence from clinical trials to evaluate the effectiveness and safety of different anti-inflammatory analgesic drugs compared with placebo, with each other or with no treatment. However, we were disappointed that we could not find any completed randomised controlled trials of these treatments or any evidence from non-randomised controlled trials. One study in CFA has recently finished and may provide some evidence when published. We suggest that there should be a randomised controlled trial to look at the effects and the safety of using anti-inflammatory drugs or painkillers or both to manage the symptoms of cystic fibrosis-related arthritis.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2008 Issue 3, Copyright © 2008 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
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January 23. 2008 AbstractBackgroundArthritis remains a relatively infrequent complication of cystic fibrosis, but is a cause of significant morbidity when it does occur. Two distinct types of arthritis are described in cystic fibrosis: cystic fibrosis-related arthropathy (CFA) and hypertrophic pulmonary osteoarthropathy (HPO). Management of arthritis in people with cystic fibrosis is uncertain and complex because of the underlying disease and its intense treatment. ObjectivesTo review the effectiveness and safety of pharmacological agents for the symptomatic management of cystic fibrosis-related arthritis in adults and children with cystic fibrosis. Search strategyWe searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register which comprises references identified from comprehensive electronic database searches, handsearches of relevant journals and abstract books of conference proceedings. Date of most recent search: March 2008. Selection criteriaRandomised controlled trials which compared the efficacy and safety of anti-inflammatory and analgesic agents (e.g. non-steroidal anti-inflammatory agents, systemic corticosteroids, intra-articular corticosteroids) with each other, with no treatment or with placebo for CFA and HPO. Data collection and analysisNo relevant studies were identified. Main resultsNo studies were included in this review. Authors' conclusionsAlthough it is generally recognised that CFA may be episodic and resolve spontaneously, treatment with analgesics and anti-inflammatory agents may be needed. While this approach may be sufficient to manage symptoms, it is disappointing that no randomised controlled trials to rigorously evaluate these agents were found, nor could the authors identify any quasi-randomised. This systematic review has identified the need for a well-designed adequately-powered randomised controlled trial to assess the efficacy and safety of pharmacological agents for the symptomatic management of cystic fibrosis-related arthritis (CFA and HPO) in adults and children with cystic fibrosis. Studies should also better define the two conditions. A study has recently been conducted in CFA and may help fill this gap when analysed and published. |