Evidence lacking for long-term opioid use in low back pain

Evidence lacking for long-term opioid use in low back pain

(HealthDay)—There is evidence of short-term efficacy (moderate for pain and small for function) of opioids for treatment of chronic low back pain (CLBP) compared with placebo; however, the effectiveness and safety of long-term opioid therapy for treatment of CLBP remains unproven, according to a review published in the April 1 issue of Spine.

Luis Enrique Chaparro, M.D., from Hospital Pablo Tobon Uribe in Medellin, Columbia, and colleagues updated a 2007 Cochrane Review to assess the efficacy of opioids in adults with CLBP. Randomized controlled trials (through October 2012) assessing the use of noninjectable opioids in CLBP for at least four weeks versus or other treatments were included. However, comparisons of different opioids were excluded.

The researchers found that 15 trials (5,540 participants), including twelve new trials, met the criteria. Compared to placebo, tramadol was better for pain and function, while transdermal buprenorphine decreased pain, compared to placebo, but did not affect function. Broadly, strong opioids (including morphine, hydromorphone, oxycodone, oxymorphone, and tapentadol) were better for pain and function than placebo. There was no difference between opioids and antidepressants for pain or function in two trials (272 participants). There were no reports of serious adverse effects, risks (addiction or overdose), or complications (sleep apnea, opioid-induced hyperalgesia, hypogonadism). Quality of the trials was low to moderate and the trials also had high dropout rates, short duration, and limited interpretability of functional improvement.

"There is evidence of short-term efficacy (moderate for and small for function) of to treat CLBP compared with placebo," the authors write.

Relevant financial activities outside the submitted work were reported: board membership, consultancy, honoraria, employment, and royalties

More information: Full Text

add to favorites email to friend print save as pdf

Related Stories

Recommended for you

Boxed warnings are common in novel therapeutics

12 hours ago

(HealthDay)—Boxed warnings are common on recent drug approvals, and many occur years after approval, according to a research letter published online Aug. 15 in JAMA Internal Medicine.

AstraZeneca says DOJ closes probe into drug trial

13 hours ago

British drugmaker AstraZeneca says the U.S. Department of Justice has closed its investigation into a clinical trial of the company's blood thinner Brilinta, and plans no further action.

Perampanel for epilepsy: Still no proof of added benefit

14 hours ago

The drug perampanel (trade name Fycompa) has been approved since July 2012 as adjunctive ("add-on") therapy for adults and children aged 12 years and older with epileptic fits (seizures). In a new early benefit assessment ...

User comments