title: [Ozone therapy in rheumatic diseases: a systematic review].
abstract: OBJECTIVE
  To perform a systematic review to analyze the efficacy on which the use of ozone therapy in musculoskeletal diseases is based.
  
  
  METHODS
  A literature search was performed in PubMed, Embase and the Cochrane Library using highly sensitive search terms to identify all studies on ozone therapy. All studies showing the efficacy or effectiveness of ozone therapy in any musculoskeletal disease were selected.
  
  
  RESULTS
  Only 6 relevant studies were identified, 5 in lumbar disk herniation and 1 in Raynaud's syndrome. Of the 5 studies in disk herniation, only 3 were clinical trials and none used random allocation. Study participants were generally patients with symptomatic small discal hernias. There was wide variability in the dose of ozone injected as well as in the controls used for comparison. All outcome measures were subjective and there was no blinded evaluation of the results. The study in Raynaud's syndrome included only 4 patients. Adverse effects were not evaluated in detail.
  
  
  CONCLUSIONS
  The use of ozone therapy in musculoskeletal diseases is based on poor quality studies. Currently, data supporting an adequate risk/benefit ratio for ozone therapy in rheumatic diseases is lacking.
authors.affiliation: Unidad de Investigación. Fundación Española de Reumatología. Madrid. España.
authors.forename: Loreto
authors.initials: L
authors.lastname: Carmona