5. Conclusion
Current evidence suggested that D. scandens might be con-
sidered as a potential alternative for NSAIDs for the treatment of
musculoskeletal pain since its use, as traditional medicine and
listed product in NLEM. The use of D. scandens as alternative
medicine could support local economy system in Thailand and it
might be safer than NSAIDs in long-term use. Concomitant use of
D. scandens and NSAIDs, should be avoided due to their similar
AEs. However, given that the overall quality of current studies is
low with short period of follow-up, firm conclusions on the effi-
cacy and safety of D. scandens cannot be drawn. Interpretation of
current evidence should be done with caution and further studies
with higher quality remain needed. In addition, dose response
effect and long-term use of standardized D. scandens products
should be further investigated.
Conflict of interest
We wish to confirm that there are no known conflicts of in-
terest associated with this publication and there has been no
significant financial support for this work that could have influ-
enced its outcome.
Acknowledgments
The authors thank Miss NakarnTanpalang for providing raw
data for combined meta-analysis and Prof. Dr. Gary H Smith for his
kindness in helping with the preparation of this article. The au-
thors have no relevant interests to declare. No external funding
was received for this work.