title: No need for rescue medication (NNR) as an easily interpretable efficacy outcome measure in analgesic trials: validation in an individual-patient meta-analysis of dental pain placebo-controlled trials of naproxen.
abstract: OBJECTIVE
  In analgesic trials, pain relief is often assessed using a pain-relief score. We aimed to assess, through a meta-analysis, whether absence of need for rescue medication (NNR) is a reliable outcome measure in the evaluation of acute pain relief.
  
  
  METHODS
  Individual-patient meta-analysis of placebo-controlled trials of single-dose naproxen sodium 220 or 440 mg in dental pain. Efficacy estimates were based on NNR and compared with the more commonly used 50% maximum total pain relief score (50% TOTPAR). The trials included were the full set of trials sponsored by one manufacturer.
  
  
  CONCLUSIONS
  Need for rescue medication and 50% TOTPAR gave comparable estimates of efficacy of naproxen sodium (220 and 440 mg) relative to placebo in dental pain at both 8 and 12 h after dosing.
  
  
  CONCLUSIONS
  No need for rescue medication is a reliable outcome measure for use in acute pain trials. As it is more readily understandable than 50% TOTPAR, it should be the preferred primary outcome measure in acute pain trials.
authors.affiliation: Centre for Evidence-Based Pharmacotherapy, Nottingham, UK. a.liwanpo@talk21.com
authors.forename: A
authors.initials: A
authors.lastname: Li-Wan-Po
authors.forename: S
authors.initials: S
authors.lastname: Chen
authors.forename: B
authors.initials: B
authors.lastname: Petersen
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D018849:Controlled Clinical Trials as Topic; D004305:Dose-Response Relationship, Drug; D006801:Humans; D009288:Naproxen / Q000008:administration & dosage / Q000627:therapeutic use*; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D015203:Reproducibility of Results; D013997:Time Factors
chemical_list: D000700:Analgesics; D009288:Naproxen