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Patients' responses to drug therapies for painful knee and hip osteoarthritis (OA) are unpredictable and often disappointing. In this network meta-analysis of nearly 200 randomized trials (each of which involved at least 100 participants), researchers examined the efficacy and safety of nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and acetaminophen in patients with knee and hip OA. Duration of most trials was 6 months or shorter. Results were as follows:
Three NSAIDs (diclofenac [150 mg daily], rofecoxib [Vioxx], and etoricoxib) were highly likely to reduce pain by more than the authors' stated minimum clinically important difference (≈10 mm on a 100-mm scale). However, in the U.S., rofecoxib was withdrawn from the market in 2004 …