Abstract
Background and Objective
This updated systematic review evaluated the efficacy, tolerability and safety of opioids compared to placebo in non‐malignant chronic low back pain.
Databases and Data Treatment
Clinicaltrials.gov, CENTRAL, MEDLINE and
PsycINFO were searched from October 2013 to May 2019. Randomized controlled trials comparing opioids with placebo and at least four weeks double‐blinded duration were analysed. Primary outcomes were pain relief of 50% or greater, disability, tolerability and safety. Effects were summarized by a random effects model using risk differences or standardized mean differences. We added nine new studies with 2980 participants for a total of 21 studies with 7650 participants. Study duration ranged between four and 15 weeks. Studies with a parallel and cross‐over design: Based on very low to low quality evidence, opioids provided no clinically relevant pain relief of 50% or greater, but a clinically relevant reduction of disability compared to placebo. Enriched enrolment randomized withdrawal (EERW) design: Based on very low to low quality evidence, opioids provided a clinically relevant pain relief of 50% or greater, but not a clinically relevant reduction of disability compared to placebo. There was no clinically relevant harm with regards serious adverse events by opioids compared to placebo in studies with parallel/cross‐over and EERW designThere was a relevant harm with regards to drop out rates due to adverse events in studies with parallel/cross‐over, but not in studies with EERW design
Conclusions
Opioids may provide a safe and clinically relevant pain relief for four to 15 weeks in highly selected patients.
from Wiley: European Journal of Pain: Table of Contents https://ift.tt/2shnwk0
via IFTTT
No comments:
Post a Comment