Trial reportPain research & management
Once-daily, controlled-release tramadol and sustained-release diclofenac relieve chronic pain due to osteoarthritis: a randomized controlled trial.
Trial report in Pain research & management. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 6 of them syntheses that pooled 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.
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.
Who cites it
21 citing papers in PubMed, 6 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- Tramadol (with or without acetaminophen) efficacy and harm: Systematic review and meta-analysis.Canadian family physician Medecin de famille canadien · 2025Pooled it
- Model-based Meta-analysis to Compare Primary Efficacy-endpoint, Efficacy-time Course, Safety, and Tolerability of Opioids Used in the Management of Osteoarthritic Pain in Humans.Current drug metabolism · 2020Pooled it
- Tramadol for osteoarthritis.The Cochrane database of systematic reviews · 2019Pooled it
- [Opioids in chronic noncancer pain-are opioids superior to nonopioid analgesics? A systematic review and meta-analysis of efficacy, tolerability and safety in randomized head-to-head comparisons of opioids versus nonopioid analgesics of at least four week's duration].Schmerz (Berlin, Germany) · 2015Pooled it
- Outcomes associated with opioid use in the treatment of chronic noncancer pain in older adults: a systematic review and meta-analysis.Journal of the American Geriatrics Society · 2010Pooled it
- The Pain and Sleep Questionnaire three-item index (PSQ-3): a reliable and valid measure of the impact of pain on sleep in chronic nonmalignant pain of various etiologies.Pain research & managementPooled it
- A randomized, double-blind, crossover comparison of the efficacy and safety of oral controlled-release tramadol and placebo in patients with painful osteoarthritis.Pain research & managementTrial
- Conservative treatment of knee osteoarthritis: A review of the literature.World journal of orthopedics · 2022Review
- Revisiting Tramadol: A Multi-Modal Agent for Pain Management.CNS drugs · 2019Review
- Article
- Emerging Trend in the Pharmacotherapy of Osteoarthritis.Frontiers in endocrinology · 2019Review
- Article
- Will the new opioid guidelines harm more people than they help? Yes.Canadian family physician Medecin de famille canadien · 2018Article
- Current research on pharmacologic and regenerative therapies for osteoarthritis.Bone research · 2016Review
- Advances in NSAID development: evolution of diclofenac products using pharmaceutical technology.Drugs · 2015Review
- PharmGKB summary: tramadol pathway.Pharmacogenetics and genomics · 2014Article
- Immunosuppressive effects of opioids--clinical relevance.Journal of neuroimmune pharmacology : the official journal of the Society on NeuroImmune Pharmacology · 2011Review
- Bridging health technology assessment (HTA) with multicriteria decision analyses (MCDA): field testing of the EVIDEM framework for coverage decisions by a public payer in Canada.BMC health services research · 2011Article
- Opioids in chronic musculoskeletal conditions.Therapeutic advances in musculoskeletal disease · 2010Article
- Management of chronic arthritis pain in the elderly.Drugs & aging · 2010Review
Corrections and comments
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Authors and funding
10 authors at 7 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe present study was a randomized, parallel, double-blind comparison between controlled-release (CR) tramadol and sustained-release (SR) diclofenac in patients with chronic pain due to osteoarthritis of the hips and/or knees.
methodsPatients with at least moderate pain intensity, and having received analgesics over the past three months, underwent a two- to seven-day washout of current analgesics before initiation of 200 mg CR tramadol or 75 mg SR diclofenac. During the eight-week study, patients returned to the clinic biweekly. CR tramadol doses were titrated to a maximum of 200 mg, 300 mg or 400 mg per day. SR diclofenac doses were titrated to 75 mg or 100 mg once daily, or 75 mg twice a day based on pain relief and the presence of side effects. For rescue analgesic, patients took acetaminophen as needed, up to 650 mg three times a day.
resultsForty-five patients on CR tramadol and 52 patients on SR diclofenac were evaluable. Significant improvements from prestudy treatment were shown for visual analogue scale pain (P=0.0001), stiffness (P<0.0005) and physical function (P=0.0001) scores for both treatments. There were no significant differences between the two treatments in the Western Ontario and McMaster Universities subscales, overall pain, pain and sleep, or the clinical effectiveness evaluation. Overall incidence of adverse events was similar in both groups, with more opioid-related adverse events with CR tramadol, and two serious adverse events occurring with the use of SR diclofenac.
conclusionsCR tramadol is as effective as SR diclofenac in the treatment of pain due to knee or hip osteoarthritis, with the potential for fewer of the serious side effects that characterize nonsteroidal anti-inflammatory drug administration.
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Registered trials
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.