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The Monoiodoacetate Model of Osteoarthritis Pain in the Mouse
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Tramadol for osteoarthritis.

Karine Toupin April1, Jacinthe Bisaillon, Vivian Welch

  • 1Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.

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|May 28, 2019
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Summary
This summary is machine-generated.

Tramadol offers no significant pain relief for osteoarthritis (OA) and increases adverse events. This review found limited benefits for tramadol in OA pain management, with higher risks of side effects.

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Area of Science:

  • Rheumatology
  • Pharmacology
  • Clinical Trials

Background:

  • Osteoarthritis (OA) is a common condition associated with pain and physical disability.
  • Tramadol is frequently prescribed for OA pain, with potential advantages over NSAIDs due to its mechanism of action.
  • This review is an update of a previous Cochrane Review from 2006.

Purpose of the Study:

  • To evaluate the benefits and harms of oral tramadol, alone or combined with acetaminophen or NSAIDs, for osteoarthritis management.
  • To synthesize evidence from randomized controlled trials (RCTs) on tramadol's efficacy and safety in OA patients.

Main Methods:

  • Systematic search of multiple databases (CENTRAL, MEDLINE, Embase) and trial registries up to February 2018.
  • Inclusion of 22 RCTs (3871 participants for tramadol, 2625 for control) evaluating tramadol versus placebo or active comparators.
  • Assessment of risk of bias, including selection, performance, and attrition bias; most trials were industry-funded.

Main Results:

  • Moderate quality evidence suggests tramadol (alone or with acetaminophen) provides no important benefit for pain or physical function compared to placebo.
  • A slightly higher proportion of patients in tramadol groups reported clinically important improvement (≥20% pain reduction).
  • Tramadol significantly increased the risk of adverse events (nausea, dizziness, tiredness) and study withdrawals due to side effects compared to placebo.

Conclusions:

  • Tramadol, alone or with acetaminophen, likely offers no significant clinical benefit for osteoarthritis pain or function.
  • Adverse events are a substantial concern, leading to more participants discontinuing tramadol treatment.
  • The evidence regarding serious adverse events with tramadol is less certain due to limited data.