Comment: The quality of evidence is downgraded by imprecise results (few studies for each comparison) and indirectness (differences in outcomes).
A Cochrane review [Abstract] 1 included 5 studies with a total of 1812 adults with frequent episodic tension-type headache (TTH). There were comparisons of aspirin 1000 mg vs. placebo (n=767), and of aspirin 500 mg or 650 mg vs. placebo (n=405). All patients treated headaches of at least moderate pain intensity.There were no data for aspirin for being pain free at 2 hours, or for being pain free at any time. Use of rescue medication was lower with aspirin 1000 mg than with placebo (2 studies, n=397); 14% of participants used rescue medication with aspirin 1000 mg vs. 31% with placebo (NNTp 6.0, 95% CI 4.1 to 12). Two studies (n=397) reported a Patient Global Evaluation at the end of the study. Aspirin 1000 mg produced more satisfied participants (55%) than placebo (37%) (NNT 5.7, 95% CI 3.7 to 12).Adverse events were not different between aspirin 1000 mg and placebo (RR 1.1, 95% CI 0.8 to 1.5), or aspirin 500 mg or 650 mg and placebo (RR 1.3, 95% CI 0.8 to 2.0). Studies reported no serious adverse events. There were insufficient data to compare aspirin with any active comparator.
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