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. 2009 Oct 7;2009(4):CD007542.
doi: 10.1002/14651858.CD007542.pub2.

Single dose oral tiaprofenic acid for acute postoperative pain in adults

Affiliations

Single dose oral tiaprofenic acid for acute postoperative pain in adults

R Andrew Moore et al. Cochrane Database Syst Rev. .

Abstract

Background: Tiaprofenic acid is a a non-steroidal anti-inflammatory drug (NSAID). It is widely available around the world, with indications for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, periarticular disorders, and strains and sprains. This review sought to evaluate the efficacy and safety of oral tiaprofenic acid in acute postoperative pain, using clinical studies of patients with established pain, and with outcomes measured primarily over 6 hours using standard methods. This type of study has been used for many decades to establish that drugs have analgesic properties.

Objectives: To assess the efficacy of single dose oral tiaprofenic acid in acute postoperative pain, and any associated adverse events.

Search strategy: We searched Cochrane CENTRAL, MEDLINE, EMBASE and the Oxford Pain Relief Database for studies to June 2009.

Selection criteria: Randomised, double blind, placebo-controlled trials of single dose orally administered tiaprofenic acid in adults with moderate to severe acute postoperative pain.

Data collection and analysis: Two review authors independently assessed trial quality and extracted data. We planned to use area under the "pain relief versus time" curve to derive the proportion of participants with tiaprofenic acid experiencing at least 50% pain relief over 4 to 6 hours, using validated equations; to use number needed to treat to benefit (NNT); the proportion of participants using rescue analgesia over a specified time period; time to use of rescue analgesia; information on adverse events and withdrawals.

Main results: Not one of eleven studies identified by the searches and examined in detail studied oral tiaprofenic acid against placebo in patients with established postoperative pain and therefore no results are available.

Authors' conclusions: In the absence of evidence of efficacy for oral tiaprofenic acid in acute postoperative pain, its use in this indication is not justified at present. Because trials clearly demonstrating analgesic efficacy in the most basic of acute pain studies is lacking, use in other indications should be evaluated carefully. Given the large number of available drugs of this and similar classes which are effective, there is no urgent research agenda for this particular drug.

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Conflict of interest statement

SD, RAM & HJM have received research support from charities, government and industry sources at various times. RAM and HJM have consulted for various pharmaceutical companies. RAM, and HJM have received lecture fees from pharmaceutical companies related to analgesics and other healthcare interventions. Support for this review came from Oxford Pain Research, the NHS Cochrane Collaboration Programme Grant Scheme, and NIHR Biomedical Research Centre Programme.

Update of

  • doi: 10.1002/14651858.CD007542

References

References to studies excluded from this review

Bornfleth 1981 {published data only}
    1. Bornfleth GH, Loeschner R. Treatment of postoperative edema and pain with the antiinflammatory agent tiaprofenic acid [Zur Behandlung postoperativer Odeme und Schmerzen mit dem Antiphlogistikum Surgam]. Therapie der Gegenwart 1981;120(8):719‐22. - PubMed
Burguet 1989 {published data only}
    1. Burguet J, Kupperberg E. Double‐blind therapeutic study comparing tiaprofenic acid and acetylsalicylic acid in dentistry. Journal Drug Development 1989;2(2):115‐7.
Cutting 1980 {published data only}
    1. Cutting CJ, Thornton EJ. A comparative trial of tiaprofenic acid ('Surgam') versus aspirin in the control of pain following injury. Pharmatherapeutica 1981;2(8):509‐12. - PubMed
Giudice 1987 {published data only}
    1. Giudice G, Rizzi F. Ketoprofen, tromethamine tiaprofenate, versus lysine acetyl salicylate in the control of postoperative pain [Ketoprofene, tiaprofenato di trometamina, versus acetil‐salicilato di lisina nel controllo del dolore post‐operatorio]. Minerva Anestesiologica 1987;53(10):587‐94. - PubMed
Lecointre 1991 {published data only}
    1. Lecointre C. Efficacy and tolerance of tiaprofenic acid for extraction complications. Results of a randomized double‐ blind study, tiaprofenic acid versus paracetamol [Efficacite et tolerance de l'acide tiaprofenique dans les suites operatoires d'extractions. Resultat d'une etude randomisee en double aveugle acide tiaporfenique versus paracetamol]. L' Information Dentaire 1991;73(35):3063‐6. - PubMed
Massin 1985 {published data only}
    1. Massin, M. Anti‐inflammatory effect of tiaprofenic acid following ocular surgery [Action anti‐inflammatoire de l'acide tiaprofenique dans les suites de la chirurgie oculaire]. Journal Francais d Opthalmologie 1985;8(8‐9):559‐63. - PubMed
Ormiston 1981 {published data only}
    1. Ormiston MC, Vaughton KC, Thornton EJ. The comparative effectiveness of tiaprofenic acid and aspirin in the treatment of post‐prostatectomy pain. British Journal of Clinical Practice 1981;35(10):360‐2. - PubMed
Salvato 1992 {published data only}
    1. Salvato A, Boldani M, Sinion M. Tiaprofenic acid in the acute treatment of postsurgical pain in dentistry. A comparative study versus nimesulide and naproxen sodium. Current Therapeutic Research ‐ Clinical and Experimental 1992;51(6):937‐45.
Trop 1983 {published data only}
    1. Trop D. Double‐blind comparative evaluation of traprofenic acid (surgam) versus acetylsalicylic acid (ASA) in relieving pain following episiotomy. Current Therapeutic Research 1983;34(2):274‐9.
van der Aa 1984 {published data only}
    1. Aa HE. A comparative trial of the analgesic effect of tiaprofenic acid and indomethacin in post‐operative pain following spinal surgery in patients with radicular syndrome. Pharmatherapeutica 1984;4(1):43‐7. - PubMed
van der Westhuijzen 1994 {published data only}
    1. Westhuijzen AJ, Roelofse JA, Grotepass FW, Becker PJ. Randomized double‐blind comparison of tiaprofenic acid and diclophenac sodium after third molar surgery. Oral Surgery, Oral Medicine, Oral Pathology 1994;78(5):557‐66. - PubMed

Additional references

Barden 2004
    1. Barden J, Edwards JE, McQuay HJ, Wiffen PJ. Relative efficacy of oral analgesics after third molar extraction. British Dental Journal 2004;197(7):407‐11. [DOI: 10.1038/sj.bdj.4811721] - DOI - PubMed
Buchbinder 2000
    1. Buchbinder R, Forbes A, Kobben F, Boyd I, Snow RM, McNeil JJ. Clinical features of tiaprofenic acid (surgam) associated cystitis and a study of risk factors for its development. Journal of Clinical Epidemiology 2000;53(10):1013‐9. [DOI: 10.1016/S0895-4356(00)00192-X] - DOI - PubMed
Clarke 2009
    1. Rachel Clarke, Sheena Derry, R Andrew Moore, Henry J McQuay. Single dose oral etoricoxib for acute postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 2. [DOI: 10.1002/14651858.CD004309.pub2] - DOI - PubMed
Collins 1997
    1. Collins SL, Moore RA, McQuay HJ. The visual analogue pain intensity scale: what is moderate pain in millimetres?. Pain 1997;72:95‐7. - PubMed
Collins 2001
    1. Collins SL, Edwards J, Moore RA, Smith LA, McQuay HJ. Seeking a simple measure of analgesia for mega‐trials: is a single global assessment good enough?. Pain 2001;91(1‐2):189‐94. [DOI: 10.1016/S0304-3959(00)00435-8] - DOI - PubMed
Cook 1995
    1. Cook RJ, Sackett DL. The number needed to treat: a clinically useful measure of treatment effect. BMJ 1995;310(6977):452‐4. - PMC - PubMed
Cooper 1991
    1. Cooper SA. Single‐dose analgesic studies: the upside and downside of assay sensitivity. The design of analgesic clinical trials. Advances in Pain Research Therapy 1991;18:117‐24.
Crawford 1997
    1. Crawford MLA, Waller PC, Wood SM. Severe cystitis associated with tiaprofenic acid. British Journal of Urology 1997;79(4):578‐84. - PubMed
Davies 1996
    1. Davies NM. Clinical pharmacokinetics of tiaprofenic acid and its enantiomers. Clinical pharmacokinetics 1996;31(5):331‐47. - PubMed
Derry 2008
    1. Derry S, Moore RA, McQuay HJ. Single dose oral celecoxib for acute postoperative pain. Cochrane Database of Systematic Reviews 2008, Issue 4. [DOI: 10.1002/14651858.CD004233] - DOI - PubMed
Derry C 2009a
    1. Derry C, Derry S, Moore RA, McQuay HJ. Single dose oral naproxen and naproxen sodium for acute postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 1. [DOI: 10.1002/14651858.CD004234.pub2] - DOI - PMC - PubMed
Derry C 2009b
    1. Derry C, Derry S, Moore RA, McQuay HJ. Single dose oral ibuprofen for acute postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 3. [DOI: 10.1002/14651858.CD001548.pub2] - DOI - PMC - PubMed
Derry P 2009
    1. Derry P, Derry S, Moore RA, McQuay HJ. Single dose oral diclofenac for acute postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 2. [DOI: 10.1002/14651858.CD004768.pub2] - DOI - PMC - PubMed
Fitzgerald 2001
    1. FitzGerald GA, Patrono C. The coxibs, selective inhibitors of cyclooxygenase‐2. New England Journal of Medicine 2001;345(6):433‐42. - PubMed
Gaskell 2009
    1. Gaskell H, Derry S, Moore RA, McQuay HJ. Single dose oral oxycodone and oxycodone plus paracetamol (acetaminophen) for acute postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 3. [DOI: 10.1002/14651858.CD002763.pub2] - DOI - PMC - PubMed
Hawkey 1999
    1. Hawkey CJ. Cox‐2 inhibitors. Lancet 1999;353(9149):307‐14. - PubMed
Jadad 1996a
    1. Jadad AR, Carroll D, Moore RA, McQuay H. Developing a database of published reports of randomised clinical trials in pain research. Pain 1996;66(2‐3):239‐46. - PubMed
Jadad 1996b
    1. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJM, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Controlled Clinical Trials 1996;17:1‐12. - PubMed
L'Abbé 1987
    1. L'Abbé KA, Detsky AS, O'Rourke K. Meta‐analysis in clinical research. Annals of Internal Medicine 1987;107:224‐33. - PubMed
Lloyd 2009
    1. Lloyd R, Derry S, Moore RA, McQuay HJ. Intravenous or intramuscular parecoxib for acute postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 2. [DOI: 10.1002/14651858.CD004771.pub4] - DOI - PMC - PubMed
McQuay 2005
    1. McQuay HJ, Moore RA. Placebo. Postgraduate Medical Journal 2005;81:155‐60. [DOI: 10.1136/pgmj.2004.024737] - DOI - PMC - PubMed
Moore 1996
    1. Moore A, McQuay H, Gavaghan D. Deriving dichotomous outcome measures from continuous data in randomised controlled trials of analgesics. Pain 1996;66(2‐3):229‐37. - PubMed
Moore 1997a
    1. Moore A, McQuay H, Gavaghan D. Deriving dichotomous outcome measures from continuous data in randomised controlled trials of analgesics: verification from independent data. Pain 1997;69(1‐2):127‐30. [DOI: 10.1016/S0304-3959(96)03251-4] - DOI - PubMed
Moore 1997b
    1. Moore A, Moore O, McQuay H, Gavaghan D. Deriving dichotomous outcome measures from continuous data in randomised controlled trials of analgesics: use of pain intensity and visual analogue scales. Pain 1997;69(3):311‐5. [DOI: 10.1016/S0304-3959(96)03306-4] - DOI - PubMed
Moore 1997c
    1. Moore RA, McQuay HJ. Single‐patient data meta‐analysis of 3453 postoperative patients: oral tramadol versus placebo, codeine and combination analgesics. Pain 1997;69(3):287‐94. [DOI: 10.1016/S0304-3959(96)03291-5] - DOI - PubMed
Moore 1998
    1. Moore RA, Gavaghan D, Tramer MR, Collins SL, McQuay HJ. Size is everything‐large amounts of information are needed to overcome random effects in estimating direction and magnitude of treatment effects. Pain 1998;8(3):209‐16. [DOI: 10.1016/S0304-3959(98)00140-7] - DOI - PubMed
Moore 2003
    1. Moore RA, Edwards J, Barden J, McQuay HJ. Bandolier's Little Book of Pain. Oxford: Oxford University Press, 2003. [ISBN: 0‐19‐263247‐7]
Moore 2005
    1. Moore RA, Edwards JE, McQuay HJ. Acute pain: individual patient meta‐analysis shows the impact of different ways of analysing and presenting results. Pain 2005;116(3):322‐31. [DOI: 10.1016/j.pain.2005.05.001] - DOI - PubMed
Moore 2006
    1. Moore A, McQuay H. Bandolier's Little Book of Making Sense of the Medical Evidence. Oxford: Oxford University Press, 2006. [ISBN: 0‐19‐856604‐2]
Moore 2008
    1. Moore RA, Barden J. Systematic review of dexketoprofen in acute and chronic pain. BMC Clinical Pharmacology 2008;8:11. [DOI: 10.1186/1472-6904-8-11] - DOI - PMC - PubMed
Morris 1995
    1. Morris JA, Gardner MJ. Calculating confidence intervals for relative risk, odds ratio and standardised ratios and rates. In: Gardner MJ, Altman DG editor(s). Statistics with Confidence ‐ Confidence Intervals and Statistical Guidelines. London: British Medical Journal, 1995:50‐63. - PMC - PubMed
PACT 2007
    1. Prescription Cost Analysis . England 2007. [ISBN: 978‐1‐84636‐210‐1]
Toms 2008
    1. Toms L, McQuay HJ, Derry S, Moore RA. Single dose oral paracetamol (acetaminophen) for postoperative pain in adults. Cochrane Database of Systematic Reviews 2008, Issue 4. [DOI: 10.1002/14651858.CD004602.pub2] - DOI - PMC - PubMed
Tramér 1997
    1. Tramèr MR, Reynolds DJM, Moore RA, McQuay HJ. Impact of covert duplicate results on meta‐analysis: a case study. BMJ 1997;315:635‐9. - PMC - PubMed

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