There was neither significant difference in the maximum performance between NSAIDs and control groups nor in the time until exhaustion nor in self-perceived pain .
Non-steroidal anti-inflammatory drugs ( NSAIDs ) are medications that are frequently used by athletes .
There may also be some abuse of these substances , although it is unclear whether NSAIDs in fact enhance performance .
We performed a systematic review and meta- analysis to evaluate the effect of NSAIDs on sport performance indices .
Ibuprofen versus placebo effect on acute kidney injury in ultramarathons: a randomised controlled trial
Background Despite concerns that non-steroidal anti-inflammatory drugs ( NSAIDs ) contribute to acute kidney injury ( AKI ) , up to 75 % of ultramarathon runners ingest these during competition . The effect of NSAID on AKI incidence in ultramarathon runners is unclear . Methods Multisite r and omised double-blind placebo-controlled trial in the Gobi , Atacama , Ecuador and Sri Lankan deserts to determine whether ibuprofen ( 400 mg every 4 hours ) would be non-inferior to placebo during a 50-mile ( 80 km ) foot race . The primary outcome was incidence of AKI defined as severity categories of ‘ risk ’ of injury of 1.5 × baseline creatinine ( Cr ) or ‘ injury ’ as 2 × Cr , combined to calculate total incidence at the finish line . Non-inferiority margin for difference in AKI rates was defined as 15 % . Results Eighty-nine participants ( 47 % ibuprofen and 53 % placebo ) were enrolled with similar demographics between groups .  The overall incidence of AKI was 44 % . Intent-to-treat analysis found 22 ( 52 % ) ibuprofen versus 16 ( 34 % ) placebo users developed AKI ( 18 % difference , 95 % CI –4 % to 41 % ; OR 2.1 , 95 % CI 0.9 to 5.1 ) with a number needed to harm of 5.5 . Greater severity of AKI was seen with ibuprofen compared with placebo ( risk=38 % vs 26 % ; 95 % CI –9 % to 34 % ; injury=14 % vs 9 % ; 95 % CI –10 % to 21 % ) . Slower finishers were less likely to encounter AKI ( OR 0.67 , 95 % CI 0.47 to 0.98 ) and greater weight loss ( −1.3 % ) increased AKI ( OR 1.24 , 95 % CI 1.00 to 1.63 ) . Conclusion There were increased rates of AKI in those who took ibuprofen , and although not statistically inferior to placebo by a small margin , there was a number needed to harm of 5.5 people to cause 1 case of AKI . Consideration should therefore be taken before ingesting NSAID during endurance running as it could exacerbate renal injury . Trial registration number NCT02272725
There was neither significant difference in the maximum performance between NSAIDs and control groups nor in the time until exhaustion nor in self-perceived pain .
Non-steroidal anti-inflammatory drugs ( NSAIDs ) are medications that are frequently used by athletes .
There may also be some abuse of these substances , although it is unclear whether NSAIDs in fact enhance performance .
We performed a systematic review and meta- analysis to evaluate the effect of NSAIDs on sport performance indices .