Cochrane · systematic review · CD002024

Alpha₂‐adrenergic agonists for the management of opioid withdrawal

Gowing, L, Farrell, M, Ali, R, et al. · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library

Drugs and Alcohol3 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
10
current version
GRADE rated
9
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 1 · 10%Very low 0 · 0%Low 5 · 50%Moderate 4 · 40%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Show all 3 versions

Alpha2‐adrenergic agonist versus methadone for the management of opioid withdrawal

Population: People undergoing managed opioid withdrawal
7 questions
OutcomeEffectEvidenceStatus / GRADE
Participants with severe withdrawal
Alpha2‐adrenergic agonist vs methadone
RR 1.18 [0.81, 1.73]5 studies · 340 participantsLow
Downgraded: risk of bias, imprecision
Peak withdrawal score
Alpha2‐adrenergic agonist vs methadone
no estimate extracted2 studies · 263 participantsModerate
Downgraded: imprecision
Overall withdrawal severity
Alpha2‐adrenergic agonist vs methadone
no estimate extracted3 studies · 119 participantsModerate
Downgraded: imprecision
Duration of treatment
Alpha2‐adrenergic agonist vs methadone
no estimate extracted3 studies · 310 participantsLow
Downgraded: risk of bias, imprecision
Number experiencing hypotensive or other adverse effects
Alpha2‐adrenergic agonist vs methadone
RR 1.92 [1.19, 3.1]6 studies · 464 participantsLow
Downgraded: risk of bias, imprecision
Drop‐out due to adverse effects
Alpha2‐adrenergic agonist vs methadone
RR 3.62 [0.77, 16.94]4 studies · 153 participantsLow
Downgraded: imprecision
Completion of treatment
Alpha2‐adrenergic agonist vs methadone
RR 0.85 [0.69, 1.05]9 studies · 659 participantsLow
Downgraded: risk of bias, inconsistency

Alpha2‐adrenergic agonist versus placebo for the management of opioid withdrawal

Population: People undergoing managed opioid withdrawal
3 questions
OutcomeEffectEvidenceStatus / GRADE
Participants with severe withdrawal
Alpha2‐adrenergic agonist vs placebo
RR 0.32 [0.18, 0.57]3 studies · 148 participantsModerate
Downgraded: imprecision
Completion of treatment
Alpha2‐adrenergic agonist vs placebo
RR 1.95 [1.34, 2.84]3 studies · 148 participantsModerate
Downgraded: imprecision
1Small number of events.
Alpha2‐adrenergic agonist vs placebo
no estimate extracted1 participantsUngraded