What are the benefits and harms of ketoprofen in adults with episodic tension-type headache?

Abstract

Compared with placebo, for adults with episodic tension‐type headache, ketoprofen 25 mg appears to provide more effective pain relief. At two and four hours, more people were pain‐free (on average, at two hours, 271 vs 161 per 1000 people [low‐certainty evidence]; at four hours, no absolute numbers available [based on 78 participants]) or had mild pain at worst (on average, at two hours, 612 vs 357 per 1000 people [moderate‐certainty evidence]; at four hours, 638 vs 453 per 1000 people [based on 426 participants]). Ketoprofen also reduced the number of people who required rescue medication (on average, 60 vs 106 per 1000 people; moderate‐certainty evidence). Compared with paracetamol 1000 mg (acetaminophen), RCTs reported no clear benefits of ketoprofen 25 mg in terms of pain relief (low‐certainty evidence) or use of rescue medication (moderate‐certainty evidence). However, more people experienced an adverse event with ketoprofen 25 mg than with placebo (on average, 95 vs 47 per 1000 people; low‐certainty evidence) or paracetamol 1000 mg (154 vs 92 per 1000 people; low‐certainty evidence), most commonly gastrointestinal or nervous system‐related. The benefit of ketoprofen over paracetamol 1000 mg for adults with episodic tension‐type headache is therefore unclear.