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Do non-steroidal anti-inflammatory drugs improve sport performance ? A meta-analysis of randomized trials Introduction

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HAL Id: hal-02143014

https://hal-hcl.archives-ouvertes.fr/hal-02143014

Submitted on 29 May 2019

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Do non-steroidal anti-inflammatory drugs improve sport performance ? A meta-analysis of randomized trials

Introduction

Catherine Cornu, Clémence Grange, Amanda Regalin, Justine Munier, Sonia Ounissi, Natane Reynaud, Behrouz Kassai-Koupai, Pierre Sallet, Patrice Nony

To cite this version:

Catherine Cornu, Clémence Grange, Amanda Regalin, Justine Munier, Sonia Ounissi, et al.. Do

non-steroidal anti-inflammatory drugs improve sport performance ? A meta-analysis of randomized

trials Introduction. 23e Congrès de la Société Française de Pharmacologie et de Thérapeutique (SFPT

2019), Jun 2019, Lyon, France. �hal-02143014�

(2)

Objective :

To perform a systematic review and meta-analysis of studies which evaluated the effect of NSAIDs on the athletic performances, i.e.

maximum performance, time to exhaustion, and pain.

The intervention included NSAIDs (including aspirin), against any control. The primary outcome was the maximal performance (as defined in each study). The secondary outcomes were the time until self-reported exhaustion and the self-reported pain.

Do non-steroidal anti-inflammatory drugs improve sport performance ? A meta-analysis of randomized trials

Catherine Cornu

1,2

, Clémence Grange

2

, Amanda Regalin

2

, Justine Munier

2

, Sonia Ounissi

2

, Natane Reynaud

2

, Behrouz Kassai-Koupai

1,2

, Pierre Sallet

3

, and Patrice Nony

2

Introduction :

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are commonly used in sports medicine. NSAIDs are over-the-counter drugs and NSAIDs are frequently taken at high doses by athletes with unrestricted access. Severe adverse effects were reported such as acute renal failure, and gastro intestinal disorders.

NSAIDs are not considered as performance enhancing drugs and are not included in the World Anti- Doping Agency (WADA) Prohibited List

SFPT LYON 2019 - PS1-002

1 INSERM CIC1407, Hospices Civils de Lyon, 2 UMR CNRS 5558 Laboratoire de Biométrie et Biologie Évolutive (LBBE)-CNRS (Unit 5558), Université Claude Bernard, Lyon (France), 3 Athletes for Transparency

Results:

8 parallel group studies and 5 crossover studies were found, totaling 178 & 75 subjects respectively. 5 parallel group studies and 2 crossover studies tested an acute dosage, and 4 parallel group studies and 3 crossover studies tested a longer period of treatment. The dosages and drugs were very disparate. There was neither significant difference in the maximum performance between groups, nor in the time until exhaustion. Self-perceived pain was significantly lower in the NSAIDs group than in the control group.

Material and methods:

Databases were searched for randomized trials involving healthy males and females, untrained or athletes, from any setting.

Maximal performance: parallel group studies

-0,38 [-0,94 ; 0,17]

I

2

= 68%

Time until exhaustion: parallel group studies

-0,08 [-0,47 ; 0,47]

I

2

= 0%

Self-perceived pain

-0,39 [-0,75 ; -0,3 I

2

= 42%

NSAIDs are not included in the World Anti-Doping Agency (WADA) Prohibited List, by lack of evidence that

they improve sports performances. Since published studies are of poor quality and design, no

conclusion can be drawn.

Discussion / Conclusion:

Our meta-analysis does not allow concluding on the existence or not of an ergogenic effect of NSAIDs on sport performance, since the quality of the studies is low, the doses tested, and the exercises performed are very heterogeneous and far from those observed in real-life practices.

However, the health risks for athletes is real and we recommend the conduct of new trials, adequately sized, methodologically sound, using adequate dosage in a real-life setting.

Risk of bias of studies:

poor quality studies

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