Cochrane · systematic review · CD005522
Tramadol for osteoarthritis
Toupin April, K, Bisaillon, J, Welch, V, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
MusculoskeletalAMSTAR 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
42
current version
GRADE rated
27
No studies
15
Included studies
NR
No studies 15 · 35.7%Ungraded 0 · 0%Very low 5 · 11.9%Low 10 · 23.8%Moderate 12 · 28.6%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
Tramadol alone compared with placebo for osteoarthritis
Population: osteoarthritis of the hip or knee, or both
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcomesa Tramadol alone vs placebo | no estimate extracted | NR | No studies |
Pain Tramadol alone vs placebo | no estimate extracted | 8 studies · 3972 participants | Moderate Downgraded: risk of bias |
Physical function Tramadol alone vs placebo | no estimate extracted | 5 studies · 2550 participants | Moderate Downgraded: risk of bias |
Number of participants experiencing any adverse events Tramadol alone vs placebo | RR 1.34 [1.24, 1.46] | 4 studies · 2039 participants | Moderate Downgraded: risk of bias |
Number of participants who withdrew due to adverse events Tramadol alone vs placebo | RR 2.64 [2.17, 3.2] | 9 studies · 4533 participants | Moderate Downgraded: risk of bias |
Number of participants experiencing any serious adverse events Tramadol alone vs placebo | RR 1.78 [1.11, 2.84] | 7 studies · 3612 participants | Low Downgraded: risk of bias, imprecision |
Tramadol in combination with acetaminophen compared with placebo for osteoarthritis
Population: osteoarthritis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcomesa Tramadol in combination with acetaminophen vs placebo | no estimate extracted | NR | No studies |
Pain Tramadol in combination with acetaminophen vs placebo | no estimate extracted | 2 studies · 614 participants | Moderate Downgraded: risk of bias |
Physical function Tramadol in combination with acetaminophen vs placebo | no estimate extracted | 2 studies · 614 participants | Moderate Downgraded: risk of bias |
Number of participants experiencing any adverse event Tramadol in combination with acetaminophen vs placebo | RR 1.91 [1.32, 2.76] | 1 study · 308 participants | Moderate Downgraded: risk of bias |
Number of participants who withdrew due to adverse events Tramadol in combination with acetaminophen vs placebo | RR 2.78 [1.5, 5.16] | 2 studies · 614 participants | Low Downgraded: risk of bias, imprecision |
Number of participants experiencing any serious adverse events Tramadol in combination with acetaminophen vs placebo | no estimate extracted | 1 study · 15 participants | Low Downgraded: imprecision |
Tramadol alone compared with acetaminophen for osteoarthritis
Population: osteoarthritis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcomesa Tramadol alone vs acetaminophen | no estimate extracted | NR | No studies |
Pain Tramadol alone vs acetaminophen | no estimate extracted | 1 study · 20 participants | Very low Downgraded: risk of bias, imprecision |
Physical function Tramadol alone vs acetaminophen | no estimate extracted | NR | No studies |
Number of participants experiencing any adverse event Tramadol alone vs acetaminophen | no estimate extracted | NR | No studies |
Number of participants who withdrew due to adverse events Tramadol alone vs acetaminophen | RR 5 [0.27, 92.62] | 1 study · 20 participants | Very low Downgraded: risk of bias, imprecision |
Number of participants experiencing any serious adverse events Tramadol alone vs acetaminophen | no estimate extracted | NR | No studies |
Tramadol alone compared with NSAIDs for osteoarthritis
Population: osteoarthritis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcomesa Tramadol alone vs NSAIDs | no estimate extracted | NR | No studies |
Pain Tramadol alone vs NSAIDs | no estimate extracted | 3 studies · 952 participants | Moderate Downgraded: risk of bias |
Physical function Tramadol alone vs NSAIDs | no estimate extracted | 3 studies · 952 participants | Low Downgraded: risk of bias, inconsistency |
Number of participants experiencing any adverse event Tramadol alone vs NSAIDs | RR 1.31 [1.03, 1.67] | 3 studies · 128 participants | Moderate Downgraded: risk of bias |
Number of participants who withdrew due to adverse events Tramadol alone vs NSAIDs | RR 1.88 [1.27, 2.76] | 2 studies · 929 participants | Low Downgraded: risk of bias, inconsistency |
Number of participants experiencing any serious adverse events Tramadol alone vs NSAIDs | RR 0.21 [0.01, 4.34] | 2 studies · 188 participants | Very low Downgraded: risk of bias, imprecision |
Tramadol alone compared with other opioids for osteoarthritis
Population: osteoarthritis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcomesa Tramadol alone vs other opioids | no estimate extracted | NR | No studies |
Pain Tramadol alone vs other opioids | no estimate extracted | 4 studies · 411 participants | Moderate Downgraded: risk of bias |
Physical function Tramadol alone vs other opioids | RR 1.32 [1.04, 1.68] | 1 study · 190 participants | Moderate Downgraded: risk of bias |
Number of participants experiencing any adverse event Tramadol alone vs other opioids | RR 0.99 [0.87, 1.13] | 3 studies · 438 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Number of participants who withdrew due to adverse events Tramadol alone vs other opioids | RR 2.26 [1.52, 3.37] | 3 studies · 438 participants | Low Downgraded: risk of bias, inconsistency |
Number of participants experiencing any serious adverse events Tramadol alone vs other opioids | RR 7.42 [0.39, 141] | 4 studies · 495 participants | Very low Downgraded: risk of bias, imprecision |
Tramadol in combination with acetaminophen compared with NSAIDs for osteoarthritis
Population: osteoarthritis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcomesa Tramadol in combination with acetaminophen vs NSAIDs | no estimate extracted | NR | No studies |
Pain Tramadol in combination with acetaminophen vs NSAIDs | no estimate extracted | 2 studies · 226 participants | Moderate Downgraded: risk of bias |
Physical function Tramadol in combination with acetaminophen vs NSAIDs | no estimate extracted | 1 study · 91 participants | Low Downgraded: risk of bias, imprecision |
Number of participants experiencing any adverse event Tramadol in combination with acetaminophen vs NSAIDs | RR 1.17 [0.87, 1.57] | 1 study · 97 participants | Low Downgraded: risk of bias, imprecision |
Number of participants who withdrew due to adverse events Tramadol in combination with acetaminophen vs NSAIDs | no estimate extracted | NR | No studies |
Number of participants experiencing any serious adverse events Tramadol in combination with acetaminophen vs NSAIDs | no estimate extracted | 1 study · 15 participants | Low Downgraded: imprecision |
Tramadol in combination with acetaminophen compared with other opioids for osteoarthritis
Population: osteoarthritis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcomesa Tramadol in combination with acetaminophen vs other opioids | no estimate extracted | NR | No studies |
Pain Tramadol in combination with acetaminophen vs other opioids | no estimate extracted | 1 study · 130 participants | Low Downgraded: risk of bias, imprecision |
Physical function Tramadol in combination with acetaminophen vs other opioids | no estimate extracted | NR | No studies |
Number of participants experiencing any adverse event Tramadol in combination with acetaminophen vs other opioids | no estimate extracted | NR | No studies |
Number of participants who withdrew due to adverse events Tramadol in combination with acetaminophen vs other opioids | no estimate extracted | NR | No studies |
Number of participants experiencing any serious adverse events Tramadol in combination with acetaminophen vs other opioids | no estimate extracted | NR | No studies |