Thornton J, Rangaraj S. Anti-inflammatory drugs and analgesics formanaging symptoms in peoplewith cystic fibrosis-relatedarthritis. Cochrane Database of Systematic Reviews 2016, Issue 1. Art. No.: CD006838. DOI: 10.1002/14651858.CD006838.pub4.

Randomised controlled trials which compared the efficacy and safety of anti-inflammatory and analgesic agents (e.g. non-steroidal anti-inflammatory agents, systemic corticosteroids, intra-articular corticosteroids) with each other, with no treatment or with placebo for CFA and HPO.

People of all ages with CF (diagnosed clinically and by sweat or genetic testing and including all degrees of disease severity) who had symptoms consistent with CF-related arthritis (for example joint pain, swelling, tenderness and limitation of movement) with clinical or radiological confirmation of the diagnosis. Studies of people with arthritis consisting of other conditions such as coexistent rheumatoid arthritis, sarcoidosis, psoriatic arthritis and drug reactions would be excluded.

anti-inflammatory and analgesic agents (non-steroidal anti-inflammatory agents, systemic corticosteroids, intra-articular corticosteroids)

Primary outcomes: 1. Joint involvement 2. Physical function 3. Quality of Life. Secondary: 1. Joint damage 2. Psychosocial outcomes 3. Socio-economic outcomes 4. Laboratory markers for chronic inflammation, for example CRP 5. Adverse effects

No studies were included in this review.

Although it is generally recognised thatCFAmay be episodic and resolve spontaneously, treatmentwith analgesics and anti-inflammatory agents may be needed. While this approach may be sufficient to manage symptoms, it is disappointing that no randomised controlled trials to rigorously evaluate these agents were found, nor could the authors identify any quasi-randomised. This systematic review has identified the need for awell-designed adequately-powered randomised controlled trial to assess the efficacy and safety of pharmacological agents for the symptomatic management of cystic fibrosis-related arthritis (CFA and HPO) in adults and children with cystic fibrosis. Studies should also better define the two conditions. A study has recently been conducted in CFA and may help fill this gap when analysed and published. There are no trials included in the review up to January 2016. We will continue to run searches to identify any potentially relevant studies; however, we do not plan to update other sections of the review until new studies are published.