Painkiller tramadol fares badly in new evidence review
Tramadol is an opioid painkiller that can be prescribed to people with osteoarthritis. Due to the way tramadol works it has been believed to have fewer adverse effects (such as gastrointestinal bleeding and kidney problems) than NSAIDS, an alternative form of pain relief.
A new review of recent studies into the benefits and harms of tramadol in osteoarthritis looked at data from 3,871 people taking tramadol and compared them to 2,625 people taking a placebo. The researchers found moderate quality evidence that:
- Tramadol alone and in combination with acetaminophen had no important benefit on pain reduction or physical function compared to the placebo group.
- Compared to placebo, there was a greater risk of developing adverse events with tramadol alone and tramadol in combination with acetaminophen. The three most frequent adverse events were nausea, dizziness and tiredness.
- There was a greater risk of withdrawing from the study because of adverse events with tramadol alone compared to placebo.
They also found low quality evidence that there was a greater risk of withdrawing from the study because of adverse events with tramadol in combination with acetaminophen compared to placebo. And there was evidence suggesting there was a greater risk of developing serious adverse events with tramadol alone compared to placebo.
“Moderate quality evidence indicates that compared to placebo, tramadol alone or in combination with acetaminophen probably has no important benefit on mean pain or function in people with osteoarthritis, although slightly more people in the tramadol group report an important improvement (defined as 20% or more),” the authors conclude. “Moderate quality evidence shows that adverse events probably cause substantially more participants to stop taking tramadol.”
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