title: Oral nonsteroidal anti-inflammatory drugs for neuropathic pain.
abstract: BACKGROUND
  Although often considered to be lacking adequate evidence, nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used in the management of neuropathic pain. Previous surveys found 18% to 47% of affected people reported using NSAIDs specifically for their neuropathic pain, although possibly not in the United Kingdom (UK).
  
  
  OBJECTIVE
  To assess the analgesic efficacy of oral NSAIDs for chronic neuropathic pain in adults, when compared to placebo or another active intervention, and the adverse events associated with its use in clinical trials.
  
  
  METHODS
  We searched CENTRAL, MEDLINE, and EMBASE from inception to 29 May 2015, together with reference lists of retrieved papers and reviews, and an online trials registry.
  
  
  METHODS
  We included randomised, double-blind studies of two weeks duration or longer, comparing any oral NSAID with placebo or another active treatment in chronic neuropathic pain.
  
  
  METHODS
  Two review authors independently searched for studies, extracted efficacy and adverse event data, and examined issues of study quality. We did not carry out any pooled analysis.
  
  
  RESULTS
  We included two studies involving 251 participants with chronic low back pain with a neuropathic component or postherpetic neuralgia; 209 of these participants were involved in a study of an experimental NSAID not used in clinical practice, and of the remaining 42, only 16 had neuropathic pain. This represented only third tier evidence, and was of very low quality. There was no indication of any significant pain reduction with NSAIDs. Adverse event rates were low, with insufficient events for any analysis.
  
  
  CONCLUSIONS
  There is no evidence to support or refute the use of oral NSAIDs to treat neuropathic pain conditions.
authors.affiliation: Pain Research and Nuffield Department of Clinical Neurosciences (Nuffield Division of Anaesthetics), University of Oxford, Pain Research Unit, Churchill Hospital, Oxford, Oxfordshire, UK, OX3 7LE.
authors.forename: R Andrew
authors.initials: RA
authors.lastname: Moore
authors.forename: Ching-Chi
authors.initials: CC
authors.lastname: Chi
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Wiffen
authors.forename: Sheena
authors.initials: S
authors.lastname: Derry
authors.forename: Andrew S C
authors.initials: AS
authors.lastname: Rice
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001416:Back Pain / Q000188:drug therapy; D000068579:Celecoxib / Q000627:therapeutic use; D006801:Humans; D009437:Neuralgia / Q000188:drug therapy*; D051474:Neuralgia, Postherpetic / Q000188:drug therapy; D000069583:Pregabalin / Q000627:therapeutic use; D011720:Pyrazoles / Q000627:therapeutic use; D011724:Pyridazines / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; C469818:GW406381X; D011720:Pyrazoles; D011724:Pyridazines; D000069583:Pregabalin; D000068579:Celecoxib