Evidence map›Paper›PMID 16856016›Full record

SynthesisThe Cochrane database of systematic reviews2006

Tramadol for neuropathic pain.

J Hollingshead, R M Dühmke, D R Cornblath

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in The Cochrane database of systematic reviews, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

47 citing papers in PubMed, 8 syntheses or guidelines pooled it, 267 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Drug therapy for chronic idiopathic axonal polyneuropathy.The Cochrane database of systematic reviews · 2017
    Pooled it
  4. Tramadol for neuropathic pain in adults.The Cochrane database of systematic reviews · 2017
    Pooled it
  5. Tramadol with or without paracetamol (acetaminophen) for cancer pain.The Cochrane database of systematic reviews · 2017
    Pooled it
  6. Opioids for neuropathic pain.The Cochrane database of systematic reviews · 2013
    Pooled it
  7. A systematic review of pharmacologic treatments of pain after spinal cord injury.Archives of physical medicine and rehabilitation · 2010
    Pooled it
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  11. Article
  12. Review
  13. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 3 institutions in 2 countries.

J HollingsheadRoyal Sussex County Hospital, Eastern Road, Brighton, UK BN2 5BE. james@hollo.org
R M Dühmke
D R Cornblath
Johns Hopkins Hospital · USPapworth Hospital · GBRoyal Sussex County Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPeripheral neuropathic pains often include symptoms such as burning or shooting sensations, abnormal sensitivity to normally painless stimuli, or an increased sensitivity to normally painful stimuli. Neuropathic pain is a common symptom in many diseases of the peripheral nervous system.

objectivesWe aimed to review systematically the evidence from randomised controlled trials for the efficacy of tramadol in treating neuropathic pain. SEARCH STRATEGY: We searched the Cochrane Neuromuscular Disease Group Trials Register (June 2005), MEDLINE (January 1966 to June 2005), EMBASE (January 1980 to June 2005), and LILACS (January 1982 to June 2005) for randomised and quasi-randomised controlled trials. We also searched bibliographies of published trials. SELECTION CRITERIA: We included randomised and quasi-randomised controlled trials comparing tramadol with placebo, other pain relieving treatment, or no treatment in people of both sexes and all ages with neuropathic pain of all degrees of severity. DATA COLLECTION AND ANALYSIS: Two authors extracted data and scored trial quality. We calculated relative risks and numbers needed to treat for effectiveness and adverse effects. MAIN

resultsWe identified six eligible trials, four comparing tramadol with placebo, one comparing tramadol with clomipramine, and one comparing tramadol with morphine. All four trials comparing tramadol with placebo showed a significant reduction in neuropathic pain with tramadol. Three of the trials which compared tramadol to placebo (total 269 participants) were combined in a meta-analysis. The number needed to treat with tramadol compared to placebo to reach at least 50% pain relief was 3.8 (95% confidence interval 2.8 to 6.3). There were insufficient data to draw conclusions about the effectiveness of tramadol compared to either clomipramine or morphine.Only one trial considered subcategories of neuropathic pain. It found a significant therapeutic effect of tramadol on paraesthesiae, allodynia, and touch evoked pain. Numbers needed to harm were calculated for side effects resulting in withdrawal from the placebo controlled trials. Three trials provided these data, and the combined number needed to harm was 8.3 (95% confidence interval 5.6 to 17). AUTHORS'

conclusionsTramadol is an effective treatment for neuropathic pain.

Indexed as

Analgesics, OpioidClomipramineHumansMorphineNervous System DiseasesPainRandomized Controlled Trials as TopicSelective Serotonin Reuptake InhibitorsTramadolAnalgesics, OpioidClomipramineMorphineSelective Serotonin Reuptake InhibitorsTramadol

Identifiers

PMID16856016
OpenAlexW1895694701

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.