Evidence map›Paper›PMID 19364730›Full record

SynthesisAnnals of the rheumatic diseases2010

Responder analysis for pain relief and numbers needed to treat in a meta-analysis of etoricoxib osteoarthritis trials: bridging a gap between clinical trials and clinical practice.

R A Moore, O A Moore, S Derry, P M Peloso, A R Gammaitoni, H Wang

Abstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Annals of the rheumatic diseases, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 121 papers, 80 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
121citing papers in PubMed, 80 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

121 citing papers in PubMed, 80 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Herbal medicinal products or preparations for neuropathic pain.The Cochrane database of systematic reviews · 2019
    Pooled it
  4. Pregabalin for neuropathic pain in adults.The Cochrane database of systematic reviews · 2019
    Pooled it
  5. Perioperative intravenous ketamine for acute postoperative pain in adults.The Cochrane database of systematic reviews · 2018
    Pooled it
  6. Mirtazapine for fibromyalgia in adults.The Cochrane database of systematic reviews · 2018
    Pooled it
  7. Cannabis-based medicines for chronic neuropathic pain in adults.The Cochrane database of systematic reviews · 2018
    Pooled it
  8. Pooled it
  9. Acupuncture for neuropathic pain in adults.The Cochrane database of systematic reviews · 2017
    Pooled it
  10. Pooled it
  11. Antiepileptic drugs for chronic non-cancer pain in children and adolescents.The Cochrane database of systematic reviews · 2017
    Pooled it
  12. Antidepressants for chronic non-cancer pain in children and adolescents.The Cochrane database of systematic reviews · 2017
    Pooled it
  13. Pooled it
  14. Pooled it
  15. Opioids for chronic non-cancer pain in children and adolescents.The Cochrane database of systematic reviews · 2017
    Pooled it
  16. Pooled it
  17. Opioids for cancer-related pain in children and adolescents.The Cochrane database of systematic reviews · 2017
    Pooled it
  18. Pooled it
  19. Oral paracetamol (acetaminophen) for cancer pain.The Cochrane database of systematic reviews · 2017
    Pooled it
  20. Tramadol for neuropathic pain in adults.The Cochrane database of systematic reviews · 2017
    Pooled it

61 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

R A MoorePain Research and Nuffield Department of Anaesthetics, University of Oxford, John Radcliffe Hospital, UK. andrew.moore@pru.ox.ac.uk
O A Moore
S Derry
P M Peloso
A R Gammaitoni
H Wang

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPopulation mean changes from clinical trials are difficult to apply to individuals in clinical practice. Responder analysis may be better, but needs validating for level of response and treatment duration.

methodsThe numbers of patients with pain relief over baseline (> or =15%, > or =30%, > or =50%, > or =70%) at 2, 4, 8 and 12 weeks of treatment were obtained using the WOMAC 100 mm visual analogue pain subscale score for each treatment group in seven randomised placebo-controlled trials of etoricoxib in osteoarthritis lasting > or =6 weeks. Dropouts were assigned 0% improvement from baseline from then on. The numbers needed to treat (NNTs) were calculated at each level of response and time point.

results3554 patients were treated with placebo, etoricoxib 30 mg and 60 mg, celecoxib 200 mg, naproxen 1000 mg or ibuprofen 2400 mg daily. Response rates fell with increasing pain relief: 60-80% experienced minimally important pain relief (> or =15%), 50-60% moderate pain relief (> or =30%), 40-50% substantial pain relief (> or =50%) and 20-30% extensive pain relief (> or =70%). NNTs for etoricoxib, celecoxib and naproxen were stable over 2-12 weeks. Ibuprofen showed lessening of effectiveness with time.

conclusionResponder rates and NNTs are reproducible for different levels of response over 12 weeks and have relevance for clinical practice at the individual patient level. An average 10 mm improvement in pain equates to almost one in two patients having substantial benefit.

Indexed as

Cyclooxygenase 2 InhibitorsDiffusion of InnovationDose-Response Relationship, DrugEtoricoxibHumansOsteoarthritis, HipOsteoarthritis, KneePainPain MeasurementPyridinesRandomized Controlled Trials as TopicSulfonesTreatment OutcomeCyclooxygenase 2 InhibitorsEtoricoxibPyridinesSulfones

Identifiers

PMID19364730
PMCPMC2800200

What OpenQuestion holds

Textmetadata
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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.