Relative efficacy of topical non-steroidal anti-inflammatory drugs and topical capsaicin in osteoarthritis: protocol for an individual patient data meta-analysis.
BACKGROUND
Pain is the most troubling issue to patients with osteoarthritis (OA), yet current pharmacological treatments offer only small-to-moderate pain reduction. Current guidelines therefore emphasise the need to identify predictors of treatment response. In line with these recommendations, an individual patient data (IPD) meta-analysis will be conducted. The study aims to investigate the relative treatment effects of topical non-steroidal anti-inflammatory drugs (NSAIDs) and topical capsaicin in OA and to identify patient-level predictors of treatment response.


METHODS
IPD will be collected from randomised controlled trials (RCTs) of topical NSAIDs and capsaicin in OA. Multilevel regression modelling will be conducted to determine predictors for the specific and the overall treatment effect.


CONCLUSIONS
Through the identification of treatment responders, this IPD meta-analysis may improve the current understanding of the pain mechanisms in OA and guide clinical decision-making. Identifying and prescribing the treatment most likely to be beneficial for an individual with OA will improve the efficiency of patient management.


BACKGROUND
CRD42016035254.
Academic Rheumatology, Clinical Sciences Building, University of Nottingham, City Hospital, Nottingham, UK.|Arthritis Research UK Pain Centre, Nottingham, UK.
Monica S M
MS
Persson
School of Healthcare, University of Leeds, Leeds, UK.
Yu
Y
Fu
Arthritis UK Centre for Sports, Exercise and Osteoarthritis, Nottingham, UK.
Archan
A
Bhattacharya
Academic Rheumatology, Clinical Sciences Building, University of Nottingham, City Hospital, Nottingham, UK.|Arthritis UK Centre for Sports, Exercise and Osteoarthritis, Nottingham, UK.|Sports Medicine Unit, University of Malaya, Kuala Lumpur, Malaysia.
Siew-Li
SL
Goh
Department of General Practice, Erasmus MC Medical University Center Rotterdam, Rotterdam, The Netherlands.
Marienke
M
van Middelkoop
Department of General Practice, Erasmus MC Medical University Center Rotterdam, Rotterdam, The Netherlands.
Sita M A
SM
Bierma-Zeinstra
Academic Rheumatology, Clinical Sciences Building, University of Nottingham, City Hospital, Nottingham, UK.|Arthritis Research UK Pain Centre, Nottingham, UK.
David
D
Walsh
Academic Rheumatology, Clinical Sciences Building, University of Nottingham, City Hospital, Nottingham, UK.|Arthritis Research UK Pain Centre, Nottingham, UK.
Michael
M
Doherty
Academic Rheumatology, Clinical Sciences Building, University of Nottingham, City Hospital, Nottingham, UK. weiya.zhang@nottingham.ac.uk.|Arthritis Research UK Pain Centre, Nottingham, UK. weiya.zhang@nottingham.ac.uk.
Weiya
W
Zhang
Capsaicin; Individual patient data meta-analysis; NSAIDs; Osteoarthritis; Topical
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