SynthesisPain2018
Neuropathic pain clinical trials: factors associated with decreases in estimated drug efficacy.
Synthesis in Pain, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 3 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
67 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Pooled it
- Quantifying the impact of concurrent analgesic use in interventional pain trials: a meta-epidemiologic study.Pain medicine (Malden, Mass.) · 2025Pooled it
- PEER systematic review of randomized controlled trials: Management of chronic neuropathic pain in primary care.Canadian family physician Medecin de famille canadien · 2021Pooled it
- Audio-visual stimulation therapy for chronic neuropathic pain: a sham-controlled randomized clinical trial.BMC neurology · 2026Trial
- Long-term efficacy of high-frequency (10 kHz) spinal cord stimulation for the treatment of painful diabetic neuropathy: 24-Month results of a randomized controlled trial.Diabetes research and clinical practice · 2023Trial
- NRD.E1, an innovative non-opioid therapy for painful diabetic peripheral neuropathy-A randomized proof of concept study.European journal of pain (London, England) · 2022Trial
- Trial
- Trial
- Traditional Chinese Manual Therapy (Tuina) relieves neuropathic pain by regulating neuroplasticity: A resting-state functional magnetic resonance imaging study.IBRO neuroscience reports · 2026Article
- A meta-analysis of pain intensity changes after placebo interventions in facial pain.Pain reports · 2026Review
- Glial cells in neuropathic pain.Physiological reviews · 2026Review
- Efficient Blended Models for Analysis and Detection of Neuropathic Pain from EEG Signals Using Machine Learning.Bioengineering (Basel, Switzerland) · 2026Article
- Advancing the Prediction and Understanding of Placebo Responses in Chronic Back Pain Using Large Language Models.European journal of pain (London, England) · 2026Article
- Dorsal Root Ganglion as a Hub for Peripheral Sensitization: A Hierarchical Regulation Model and Translational Progress.Journal of pain research · 2026Review
- Ultrasound-Guided Interventions for Neuropathic Pain: A Narrative Pictorial Review.Life (Basel, Switzerland) · 2025Review
- Neurophysiology of acute and chronic pain: from genes to pain symptoms.BJA education · 2025Review
- A Systematic Review of Lifestyle Interventions for Neuropathy and Neuropathic Pain: Smoking Cessation.NeuroSci · 2025Review
- Cholesterol metabolism and neuroinflammatory changes in a non-human primate spinal nerve ligation model.Scientific reports · 2025Article
- An update on non-pharmacological interventions for pain relief.Cell reports. Medicine · 2025Review
- Electrophysiology in neuropathic pain: a bibliometric analysis and literature review.Frontiers in neuroscience · 2025Review
7 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Funding
Abstract
Multiple recent pharmacological clinical trials in neuropathic pain have failed to show beneficial effect of drugs with previously demonstrated efficacy, and estimates of drug efficacy seems to have decreased with accumulation of newer trials. However, this has not been systematically assessed. Here, we analyze time-dependent changes in estimated treatment effect size in pharmacological trials together with factors that may contribute to decreases in estimated effect size. This study is a secondary analysis of data from a previous published NeuPSIG systematic review and meta-analysis, updated to include studies published up till March 2017. We included double-blind, randomized, placebo-controlled trials examining the effect of drugs for which we had made strong or weak recommendations for use in neuropathic pain in the previously published review. As the primary outcome, we used an aggregated number needed to treat for 50% pain reduction (alternatively 30% pain reduction or moderate pain relief). Analyses involved 128 trials. Number needed to treat values increased from around 2 to 4 in trials published between 1982 and 1999 to much higher (less effective) values in studies published from 2010 onwards. Several factors that changed over time, such as larger study size, longer study duration, and more studies reporting 50% or 30% pain reduction, correlated with the decrease in estimated drug effect sizes. This suggests that issues related to the design, outcomes, and reporting have contributed to changes in the estimation of treatment effects. These factors are important to consider in design and interpretation of individual study data and in systematic reviews and meta-analyses.
Indexed as
Identifiers
What OpenQuestion holds
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.