Tolerability of Opioid Analgesia for Chronic Pain: A Network Meta-Analysis

Abstract Aim of this study was to study the tolerability of opioid analgesia by performing a network meta-analysis (NMA) of randomized-controlled trials (RCTs) which investigated effectiveness of opioids for the management of chronic pain. Research articles reporting outcomes of RCT/s comparing 2 or...

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Autores principales:	Zengdong Meng, Jing Yu, Michael Acuff, Chong Luo, Sanrong Wang, Lehua Yu, Rongzhong Huang
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/6aa5498e57cb43168f88aa05e8a5d915
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spelling	oai:doaj.org-article:6aa5498e57cb43168f88aa05e8a5d9152021-12-02T11:52:28ZTolerability of Opioid Analgesia for Chronic Pain: A Network Meta-Analysis10.1038/s41598-017-02209-x2045-2322https://doaj.org/article/6aa5498e57cb43168f88aa05e8a5d9152017-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-02209-xhttps://doaj.org/toc/2045-2322Abstract Aim of this study was to study the tolerability of opioid analgesia by performing a network meta-analysis (NMA) of randomized-controlled trials (RCTs) which investigated effectiveness of opioids for the management of chronic pain. Research articles reporting outcomes of RCT/s comparing 2 or more opioid analgesics for the management of chronic pain were obtained by database search. Bayesian NMAs were performed to combine direct comparisons between treatments with that of indirect simulated evidence. Study endpoints were: incidence of adverse events, incidence of constipation, trial withdrawal rate, and patient satisfaction with treatment. Outcomes were also compared with conventional meta-analyses. Thirty-two studies investigating 10 opioid drugs fulfilled the eligibility criteria. Tapentadol treatment was top-ranking owing to lower incidence of overall adverse events, constipation, and least trial withdrawal rate. Tapentadol was followed by oxycodone-naloxone combination in providing better tolerability and less trial withdrawal rate. Patient satisfaction was found to be higher with oxycodone-naloxone followed by fentanyl and tapentadol. These results were in agreement with those achieved with conventional meta-analyses. Tapentadol and oxycodone-naloxone are found to exhibit better tolerability characteristics in comparison with other opioid drugs for the management of chronic pain and are associated with low trial withdrawal rate and better patient satisfaction.Zengdong MengJing YuMichael AcuffChong LuoSanrong WangLehua YuRongzhong HuangNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-9 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Zengdong Meng Jing Yu Michael Acuff Chong Luo Sanrong Wang Lehua Yu Rongzhong Huang Tolerability of Opioid Analgesia for Chronic Pain: A Network Meta-Analysis
description	Abstract Aim of this study was to study the tolerability of opioid analgesia by performing a network meta-analysis (NMA) of randomized-controlled trials (RCTs) which investigated effectiveness of opioids for the management of chronic pain. Research articles reporting outcomes of RCT/s comparing 2 or more opioid analgesics for the management of chronic pain were obtained by database search. Bayesian NMAs were performed to combine direct comparisons between treatments with that of indirect simulated evidence. Study endpoints were: incidence of adverse events, incidence of constipation, trial withdrawal rate, and patient satisfaction with treatment. Outcomes were also compared with conventional meta-analyses. Thirty-two studies investigating 10 opioid drugs fulfilled the eligibility criteria. Tapentadol treatment was top-ranking owing to lower incidence of overall adverse events, constipation, and least trial withdrawal rate. Tapentadol was followed by oxycodone-naloxone combination in providing better tolerability and less trial withdrawal rate. Patient satisfaction was found to be higher with oxycodone-naloxone followed by fentanyl and tapentadol. These results were in agreement with those achieved with conventional meta-analyses. Tapentadol and oxycodone-naloxone are found to exhibit better tolerability characteristics in comparison with other opioid drugs for the management of chronic pain and are associated with low trial withdrawal rate and better patient satisfaction.
format	article
author	Zengdong Meng Jing Yu Michael Acuff Chong Luo Sanrong Wang Lehua Yu Rongzhong Huang
author_facet	Zengdong Meng Jing Yu Michael Acuff Chong Luo Sanrong Wang Lehua Yu Rongzhong Huang
author_sort	Zengdong Meng
title	Tolerability of Opioid Analgesia for Chronic Pain: A Network Meta-Analysis
title_short	Tolerability of Opioid Analgesia for Chronic Pain: A Network Meta-Analysis
title_full	Tolerability of Opioid Analgesia for Chronic Pain: A Network Meta-Analysis
title_fullStr	Tolerability of Opioid Analgesia for Chronic Pain: A Network Meta-Analysis
title_full_unstemmed	Tolerability of Opioid Analgesia for Chronic Pain: A Network Meta-Analysis
title_sort	tolerability of opioid analgesia for chronic pain: a network meta-analysis
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/6aa5498e57cb43168f88aa05e8a5d915
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Tolerability of Opioid Analgesia for Chronic Pain: A Network Meta-Analysis

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