Cochrane · systematic review · CD010967
Topical clonidine for neuropathic pain in adults
Serednicki, WT, Wrzosek, A, Woron, J, et al. · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library
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
14
current version
GRADE rated
8
No studies
6
Included studies
NR
No studies 6 · 42.9%Ungraded 0 · 0%Very low 1 · 7.1%Low 7 · 50%Moderate 0 · 0%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
Current version onlyTopical clonidine (TC) compared with placebo for chronic neuropathic pain in adults
Population: adults with painful diabetic neuropathy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Participant‐reported pain relief of 50% or greater during longest Topical clonidine (TC) vs placebo | RR 1.21 [0.78, 1.86] | 1 study · 179 participants | Low Downgraded: risk of bias, imprecision |
Participant‐reported pain relief of 30% or greater during longest Topical clonidine (TC) vs placebo | RR 1.35 [1.03, 1.77] | 2 studies · 344 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Much or very much improved on PGIC during longest Topical clonidine (TC) vs placebo | RR 1.06 [0.76, 1.49] | 1 study · 179 participants | Low Downgraded: risk of bias, imprecision |
Very much improved on PGIC during longest Topical clonidine (TC) vs placebo | RR 1.82 [0.89, 3.72] | 1 study · 179 participants | Low Downgraded: risk of bias, imprecision |
Withdrawals due to adverse events during longest Topical clonidine (TC) vs placebo | RR 0.34 [0.04, 3.18] | 1 study · 179 participants | Low Downgraded: risk of bias, imprecision |
Participants experiencing at least 1adverse event during longest Topical clonidine (TC) vs placebo | RR 0.65 [0.14, 3.05] | 2 studies · 344 participants | Low Downgraded: risk of bias, imprecision |
Withdrawal due to lack of efficacy (12 weeks) Topical clonidine (TC) vs placebo | RR 1.01 [0.06, 15.92] | 1 study · 179 participants | Low Downgraded: risk of bias, imprecision |
Topical clonidine (TC) compared with active comparator for chronic neuropathic pain in adults
Population: adults with painful diabetic neuropathy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Participant‐reported pain relief of 50% or greater during longest Topical clonidine (TC) vs active comparator | RR 1.41 [0.99, 2] | 1 study · 139 participants | Low Downgraded: risk of bias, imprecision |
Participant‐reported pain relief of 30% or greater during longest Topical clonidine (TC) vs active comparator | no estimate extracted | NR | No studies |
Much or very much improved on PGIC during longest Topical clonidine (TC) vs active comparator | no estimate extracted | NR | No studies |
Very much improved on PGIC during longest Topical clonidine (TC) vs active comparator | no estimate extracted | NR | No studies |
Withdrawals due to adverse events during longest Topical clonidine (TC) vs active comparator | no estimate extracted | NR | No studies |
Participants experiencing at least 1adverse event during longest Topical clonidine (TC) vs active comparator | no estimate extracted | NR | No studies |
Withdrawal due to lack of efficacy (12 weeks) Topical clonidine (TC) vs active comparator | no estimate extracted | NR | No studies |
Comparison
Population: adult patients with PDN
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain intensity reduction ≥ 50% ( | RR 1.21 | 1 study · 179 participants | Low |
Pain intensity reduction ≥ 30% ( | RR 1.35 | 2 studies · 344 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
PGIC much or very much improved ( | RR 1.06 | 1 study · 179 participants | Low |
PGIC very much improved ( | RR 1.82 | 1 study · 179 participants | Very low |
Withdrawals due to adverse events ( | RR 0.33 | 1 study · 179 participants | Very low |
Participants with ≥ 1 adverse event ( | RR 0.65 | 2 studies · 344 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Participants experiencing any serious adverse event | no estimate extracted | 2009 participants | Ungraded |
Rate of withdrawal due to lack of efficacy | RR 1.01 | 1 study · 179 participants | Very low |