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Abstract：
UNASSIGNED: Tension-type headache is the most common type of primary headache and results in a huge socioeconomic burden. This network meta-analysis (NMA) aimed to compare the efficacy and safety of simple analgesics for the treatment of episodic tension-type headache (ETTH) in adults.
UNASSIGNED: We searched the Cochrane Library, PubMed, Web of Science, Embase, Chinese BioMedical Literature database and International Clinical Trials Registry Platform databases for eligible randomized clinical trials reporting the efficacy and/or safety of simple analgesics. A Bayesian NMA was performed to compare relative efficacy and safety. The surface under the cumulative ranking curve (SUCRA) was calculated to rank interventions. PROSPERO registration number: CRD42018090554.
UNASSIGNED: We highlighted six studies including 3507 patients. For the 2 h pain-free rate, the SUCRA ranking was ibuprofen > diclofenac-K > ketoprofen > acetaminophen > naproxen > placebo. All drugs except naproxen reported a higher 2 h pain-free rate than placebo, with a risk ratio (RR) of 2.86 (95% credible interval, CrI: 1.62-5.42) for ibuprofen and 2.61 (1.53-4.88) for diclofenac-K. For adverse events rate, the SUCRA ranking was: metamizol > diclofenac-K > ibuprofen > lumiracoxib > placebo > aspirin > acetaminophen > naproxen > ketoprofen. The adverse event rates of all analgesics were no higher than those of placebo, except for ketoprofen. Moreover, all drugs were superior to placebo in the global assessment of efficacy. In particular, the RR of lumiracoxib was 2.47 (1.57-4.57). Global heterogeneity I2 between the studies was low.
UNASSIGNED: Simple analgesics are considered more effective and safe as a placebo for ETTH in adults. Our results suggest that ibuprofen and diclofenac-K may be the two best treatment options for patients with ETTH from a comprehensive point of view (both high-quality evidence).
To our knowledge, this is the first network meta-analysis comparing the available data on adult patients with episodic tension-type headache (ETTH) treated with different simple analgesics recommended by the current guidelines.Ibuprofen (400 mg) and diclofenac-K (12.5 mg, 25 mg) are potentially the most effective and safe treatment options, supported by high-quality evidence.
UNASSIGNED: We searched the Cochrane Library, PubMed, Web of Science, Embase, Chinese BioMedical Literature database and International Clinical Trials Registry Platform databases for eligible randomized clinical trials reporting the efficacy and/or safety of simple analgesics. A Bayesian NMA was performed to compare relative efficacy and safety. The surface under the cumulative ranking curve (SUCRA) was calculated to rank interventions. PROSPERO registration number: CRD42018090554.
UNASSIGNED: We highlighted six studies including 3507 patients. For the 2 h pain-free rate, the SUCRA ranking was ibuprofen > diclofenac-K > ketoprofen > acetaminophen > naproxen > placebo. All drugs except naproxen reported a higher 2 h pain-free rate than placebo, with a risk ratio (RR) of 2.86 (95% credible interval, CrI: 1.62-5.42) for ibuprofen and 2.61 (1.53-4.88) for diclofenac-K. For adverse events rate, the SUCRA ranking was: metamizol > diclofenac-K > ibuprofen > lumiracoxib > placebo > aspirin > acetaminophen > naproxen > ketoprofen. The adverse event rates of all analgesics were no higher than those of placebo, except for ketoprofen. Moreover, all drugs were superior to placebo in the global assessment of efficacy. In particular, the RR of lumiracoxib was 2.47 (1.57-4.57). Global heterogeneity I2 between the studies was low.
UNASSIGNED: Simple analgesics are considered more effective and safe as a placebo for ETTH in adults. Our results suggest that ibuprofen and diclofenac-K may be the two best treatment options for patients with ETTH from a comprehensive point of view (both high-quality evidence).
To our knowledge, this is the first network meta-analysis comparing the available data on adult patients with episodic tension-type headache (ETTH) treated with different simple analgesics recommended by the current guidelines.Ibuprofen (400 mg) and diclofenac-K (12.5 mg, 25 mg) are potentially the most effective and safe treatment options, supported by high-quality evidence.
摘要：
■紧张型头痛是最常见的原发性头痛类型，并导致巨大的社会经济负担。此网络荟萃分析（NMA）旨在比较简单镇痛药治疗成人发作性紧张型头痛（ETTH）的疗效和安全性。
■我们搜索了Cochrane图书馆,PubMed,WebofScience,Embase,中国生物医学文献数据库和国际临床试验注册平台数据库，用于报告简单镇痛药的疗效和/或安全性的合格随机临床试验。进行贝叶斯NMA以比较相对疗效和安全性。计算累积排序曲线(SUCRA)下的表面以对干预进行排序。PROSPERO注册号：CRD42018090554。
■我们强调了六项研究，包括3507名患者。对于2小时无痛率，SUCRA排名为布洛芬>双氯芬酸-K>酮洛芬>对乙酰氨基酚>萘普生>安慰剂。除萘普生外，所有药物均报告2h无痛率高于安慰剂，风险比(RR)为2.86(95%可信区间，CRI：布洛芬为1.62-5.42），双氯芬酸为2.61（1.53-4.88）。对于不良事件发生率，SUCRA排名为:安乃近>双氯芬酸-K>布洛芬>lumiracoxib>安慰剂>阿司匹林>对乙酰氨基酚>萘普生>酮洛芬。所有镇痛药的不良事件发生率均不高于安慰剂，除了酮洛芬.此外，在全球疗效评估中,所有药物均优于安慰剂.特别是,lumiracxib的RR为2.47（1.57-4.57）。研究之间的全球异质性I2较低。
■作为成人ETTH的安慰剂，简单的镇痛药被认为更有效和安全。我们的结果表明，布洛芬和双氯芬酸-K可能是ETTH患者的两种最佳治疗选择（均为高质量证据）。
据我们所知,这是首次网络荟萃分析,比较了使用本指南推荐的不同简单镇痛药治疗的阵发性紧张型头痛(ETTH)成年患者的现有数据.布洛芬（400毫克）和双氯芬酸K（12.5毫克，25毫克)可能是最有效和安全的治疗选择，有高质量证据支持。
■我们搜索了Cochrane图书馆,PubMed,WebofScience,Embase,中国生物医学文献数据库和国际临床试验注册平台数据库，用于报告简单镇痛药的疗效和/或安全性的合格随机临床试验。进行贝叶斯NMA以比较相对疗效和安全性。计算累积排序曲线(SUCRA)下的表面以对干预进行排序。PROSPERO注册号：CRD42018090554。
■我们强调了六项研究，包括3507名患者。对于2小时无痛率，SUCRA排名为布洛芬>双氯芬酸-K>酮洛芬>对乙酰氨基酚>萘普生>安慰剂。除萘普生外，所有药物均报告2h无痛率高于安慰剂，风险比(RR)为2.86(95%可信区间，CRI：布洛芬为1.62-5.42），双氯芬酸为2.61（1.53-4.88）。对于不良事件发生率，SUCRA排名为:安乃近>双氯芬酸-K>布洛芬>lumiracoxib>安慰剂>阿司匹林>对乙酰氨基酚>萘普生>酮洛芬。所有镇痛药的不良事件发生率均不高于安慰剂，除了酮洛芬.此外，在全球疗效评估中,所有药物均优于安慰剂.特别是,lumiracxib的RR为2.47（1.57-4.57）。研究之间的全球异质性I2较低。
■作为成人ETTH的安慰剂，简单的镇痛药被认为更有效和安全。我们的结果表明，布洛芬和双氯芬酸-K可能是ETTH患者的两种最佳治疗选择（均为高质量证据）。
据我们所知,这是首次网络荟萃分析,比较了使用本指南推荐的不同简单镇痛药治疗的阵发性紧张型头痛(ETTH)成年患者的现有数据.布洛芬（400毫克）和双氯芬酸K（12.5毫克，25毫克)可能是最有效和安全的治疗选择，有高质量证据支持。
