PMID- 34251756
OWN - NLM
STAT- MEDLINE
DCOM- 20221230
LR  - 20230215
IS  - 2151-4658 (Electronic)
IS  - 2151-464X (Linking)
VI  - 75
IP  - 1
DP  - 2023 Jan
TI  - Efficacy and Safety of Tramadol for Knee or Hip Osteoarthritis: A Systematic 
      Review and Network Meta-Analysis of Randomized Controlled Trials.
PG  - 158-165
LID - 10.1002/acr.24750 [doi]
AB  - OBJECTIVE: To examine efficacy and safety of tramadol for knee or hip 
      osteoarthritis (OA). METHODS: PubMed, Embase, Cochrane Library, and Web of 
      Science were searched up to May 2020 for randomized controlled trials (RCTs) 
      comparing any of the following interventions: tramadol 100 mg/day, 200 mg/day, 
      and 300 mg/day, and placebo for knee or hip OA. Pain and function were measured 
      at or near 12 weeks for efficacy. Gastrointestinal, cardiovascular, and central 
      nervous system (CNS) adverse events (AEs), and withdrawals were measured for 
      safety. Bayesian network meta-analysis was conducted. RESULTS: Six RCTs (3,611 
      participants) were included. Tramadol 100 mg/day (standardized mean difference 
      [SMD] -0.16 [95% confidence interval (95% CI) -0.34, 0.00]), 200 mg/day (SMD 
      -0.21 [95% CI -0.37, -0.06]), and 300 mg/day (SMD -0.30 [95% CI -0.48, -0.14]) 
      were statistically more effective than placebo in pain relief, but only tramadol 
      300 mg/day was better than placebo in functional improvement (SMD -0.24 [95% CI 
      -0.47, -0.03]). Tramadol 100 mg/day (relative risk [RR] 2.29 [95% credible 
      interval (CrI) 1.22, 4.25]), 200 mg/day (RR 4.35 [95% CrI 2.31, 8.01]), and 300 
      mg/day (RR 6.02 [95% CrI 3.22, 11.1]) involved a higher risk of gastrointestinal 
      AEs. Similarly, tramadol 100-300 mg/day showed a higher risk of CNS AEs and 
      withdrawals. However, the risk of cardiovascular AEs remained unclear. 
      CONCLUSION: Only tramadol 300 mg/day showed minimal improvement in pain and 
      function but with increasing AEs compared with placebo. Tramadol may not be 
      sufficiently recommended for knee or hip OA based on the presented evidence, 
      especially in patients with the risk of gastrointestinal and CNS AEs.
CI  - (c) 2021 American College of Rheumatology.
FAU - Zhang, Xiurui
AU  - Zhang X
AUID- ORCID: 0000-0002-5033-2084
AD  - Xiangya Hospital, Central South University, Changsha, Hunan, China.
FAU - Li, Xiaoxiao
AU  - Li X
AD  - Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, Hunan, China.
FAU - Xiong, Yilin
AU  - Xiong Y
AD  - Xiangya Hospital, Central South University, Changsha, Hunan, China.
FAU - Wang, Yilun
AU  - Wang Y
AD  - Xiangya Hospital, Central South University, Changsha, Hunan, China.
FAU - Wei, Jie
AU  - Wei J
AD  - Xiangya Hospital, Central South University, Changsha, Hunan, China.
FAU - Zeng, Chao
AU  - Zeng C
AD  - Hunan Key Laboratory of Joint Degeneration and Injury and Xiangya Hospital, 
      Central South University, Changsha, Hunan, China.
FAU - Sha, Tingting
AU  - Sha T
AD  - Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, Hunan, China.
FAU - Lei, Guanghua
AU  - Lei G
AUID- ORCID: 0000-0003-2987-138X
AD  - Hunan Key Laboratory of Joint Degeneration and Injury and Xiangya Hospital, 
      Central South University, Changsha, Hunan, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20220823
PL  - United States
TA  - Arthritis Care Res (Hoboken)
JT  - Arthritis care & research
JID - 101518086
RN  - 39J1LGJ30J (Tramadol)
SB  - IM
MH  - Humans
MH  - *Osteoarthritis, Hip/diagnosis/drug therapy
MH  - *Tramadol/adverse effects
MH  - *Osteoarthritis, Knee/diagnosis/drug therapy
MH  - Network Meta-Analysis
MH  - Randomized Controlled Trials as Topic
MH  - Pain
EDAT- 2021/07/13 06:00
MHDA- 2022/12/31 06:00
CRDT- 2021/07/12 13:18
PHST- 2021/06/09 00:00 [revised]
PHST- 2020/11/23 00:00 [received]
PHST- 2021/07/08 00:00 [accepted]
PHST- 2021/07/13 06:00 [pubmed]
PHST- 2022/12/31 06:00 [medline]
PHST- 2021/07/12 13:18 [entrez]
AID - 10.1002/acr.24750 [doi]
PST - ppublish
SO  - Arthritis Care Res (Hoboken). 2023 Jan;75(1):158-165. doi: 10.1002/acr.24750. 
      Epub 2022 Aug 23.