Ibuprofen

No drug was tested against another here. These are numbers from separate trials in separate people, lined up side by side. The authors flag 13 of the drug and dose pairs as possibly affected by publication bias. All of it is a single dose for pain after an operation, which says nothing about taking either drug for weeks. And the arithmetic that makes the pair work is the same arithmetic that makes an unnoticed second acetaminophen product dangerous.

Most of the underlying data come from wisdom-tooth extraction in otherwise healthy adults, a standardised research model rather than everyday pain. These are single doses measured over four to six hours and say nothing about taking something repeatedly. The overview ran no statistical test between the drugs, so these numbers sit side by side and were never compared. Some drug and dose combinations were judged unreliable because of susceptibility to publication bias.

The best diclofenac figure rests on two studies, and some of the ketoprofen data come from 1980s trials with loosely defined outcomes. Around 5,900 participants' worth of registered but never fully reported efficacy data was identified and could not be obtained, which is the direction publication bias usually runs. Only 220 people across all 61 trials were given a tablet for comparison, so the comparison with swallowing one is thin.

This is a second analysis of the same 31 participants, not an independent replication, so it inherits that trial's size and design unchanged. A null result across the markers measured narrows the candidates rather than showing that no mechanism exists. Muscle fibre size specifically was unaffected, which sits awkwardly next to the whole-muscle scan difference the earlier report described, and the authors do not reconcile the two.

This is a reference monograph summarising labelling and formulary convention, not a study of what either ceiling does to anyone. The figures are United States labelling and differ by country. Monograph entries are revised continuously, so a later version may read differently.

An online self-reported diary, so what people recorded may not be what they swallowed, and volunteers who sign up online are not a random sample. Going over the limit was worked out from the recorded times and doses, never checked against an independent record. The study counted behaviour and not harm, so it cannot say how many of those days caused anyone a problem. It ran in the United States, where pack sizes and single-pill doses differ from other markets.

These come from observational studies whose definitions of a serious complication and methods of recording who took what varied, which the authors flag themselves. The intervals are wide for the less-studied drugs, running from 1.07 to 17.81 for diflunisal. No absolute risk is supplied, and it turns heavily on age and ulcer history. Several of the drugs ranked are not in common use in most markets.

Nearly seven in ten participants stopped taking the study drug and more than a quarter stopped follow-up altogether, which blunts every comparison the trial makes. It was funded by celecoxib's manufacturer. A non-inferiority design can show one drug is not clearly worse than another; it cannot show that any of them is safe. Everyone enrolled had arthritis and raised cardiovascular risk.

Whether celecoxib is as heart-safe as ibuprofen and naproxen is unsettled. Prescribing data rank it riskier; the one large trial found it no worse but dosed the drugs unequally, and no study has compared them at matched doses.

Thirty-one people in one trial and thirty-six in the other, one muscle group each. The comparators were not the same: the younger trial used low-dose aspirin rather than a true placebo, so it set a high dose against a low one rather than a drug against nothing. The training protocols and durations differed too, eight weeks against twelve. The older trial's authors state the direction was the opposite of what they expected.

Ibuprofen during strength training roughly halved muscle growth in young adults and added to it in older ones. Age, comparator, training and programme length all differed, so what flips the effect is unknown.

Eighty-nine runners, and the 18-point gap was not statistically significant, with an interval running from 4 points the other way to 41 points in favour. Kidney injury here means a creatinine rise measured at the finish line, a marker that often settles, not a clinical kidney outcome with follow-up. Runners who lost more weight during the race were independently more likely to be affected, so dehydration and the drug are tangled together in these numbers. Multi-day desert racing in heat is a deliberately stressed setting.