BACKGROUND: Neuropathic pain (NP) encompasses many difficult-to-treat disorders. There are few head-to-head, comparative, randomized controlled trials (RCTs) of drugs for NP in different analgesic categories, or of different drugs within a category, despite many placebo-controlled RCTs for individual agents. Well-designed head-to-head comparative trials are an effective way to determine the relative efficacy and safety of a new drug. OBJECTIVE: To perform a systematic review of head-to-head RCTs of oral analgesics in NP. METHODS: A systematic review of RCTs involving NP patients was performed, of which head-to-head comparative trials were selected. Reference lists from published systematic reviews were searched. These studies were rated according to the Jadad scale for quality. RESULTS AND CONCLUSIONS: Twenty-seven such trials were identified. Seventeen were comparisons of different analgesics, and 10 were of different drugs within an analgesic class. Important information was obtained about the relative efficacy and safety of drugs in different categories and within a category. Some significant differences between active treatments were reported. Trial inadequacies were identified. More and improved head-to-head RCTs are needed to inform clinical choices.
BACKGROUND:Neuropathic pain (NP) encompasses many difficult-to-treat disorders. There are few head-to-head, comparative, randomized controlled trials (RCTs) of drugs for NP in different analgesic categories, or of different drugs within a category, despite many placebo-controlled RCTs for individual agents. Well-designed head-to-head comparative trials are an effective way to determine the relative efficacy and safety of a new drug. OBJECTIVE: To perform a systematic review of head-to-head RCTs of oral analgesics in NP. METHODS: A systematic review of RCTs involving NP patients was performed, of which head-to-head comparative trials were selected. Reference lists from published systematic reviews were searched. These studies were rated according to the Jadad scale for quality. RESULTS AND CONCLUSIONS: Twenty-seven such trials were identified. Seventeen were comparisons of different analgesics, and 10 were of different drugs within an analgesic class. Important information was obtained about the relative efficacy and safety of drugs in different categories and within a category. Some significant differences between active treatments were reported. Trial inadequacies were identified. More and improved head-to-head RCTs are needed to inform clinical choices.
Authors: Robert H Dworkin; Dennis C Turk; Sarah Peirce-Sandner; Ralf Baron; Nicholas Bellamy; Laurie B Burke; Amy Chappell; Kevin Chartier; Charles S Cleeland; Ann Costello; Penney Cowan; Rozalina Dimitrova; Susan Ellenberg; John T Farrar; Jacqueline A French; Ian Gilron; Sharon Hertz; Alejandro R Jadad; Gary W Jay; Jarkko Kalliomäki; Nathaniel P Katz; Robert D Kerns; Donald C Manning; Michael P McDermott; Patrick J McGrath; Arvind Narayana; Linda Porter; Steve Quessy; Bob A Rappaport; Christine Rauschkolb; Bryce B Reeve; Thomas Rhodes; Cristina Sampaio; David M Simpson; Joseph W Stauffer; Gerold Stucki; Jeffrey Tobias; Richard E White; James Witter Journal: Pain Date: 2010-03-06 Impact factor: 6.961
Authors: K Kieburtz; D Simpson; C Yiannoutsos; M B Max; C D Hall; R J Ellis; C M Marra; R McKendall; E Singer; G J Dal Pan; D B Clifford; T Tucker; B Cohen Journal: Neurology Date: 1998-12 Impact factor: 9.910
Authors: S F Carville; L Arendt-Nielsen; S Arendt-Nielsen; H Bliddal; F Blotman; J C Branco; D Buskila; J A P Da Silva; B Danneskiold-Samsøe; F Dincer; C Henriksson; K G Henriksson; E Kosek; K Longley; G M McCarthy; S Perrot; M Puszczewicz; P Sarzi-Puttini; A Silman; M Späth; E H Choy Journal: Ann Rheum Dis Date: 2007-07-20 Impact factor: 19.103
Authors: Robert R Edwards; Robert H Dworkin; Dennis C Turk; Martin S Angst; Raymond Dionne; Roy Freeman; Per Hansson; Simon Haroutounian; Lars Arendt-Nielsen; Nadine Attal; Ralf Baron; Joanna Brell; Shay Bujanover; Laurie B Burke; Daniel Carr; Amy S Chappell; Penney Cowan; Mila Etropolski; Roger B Fillingim; Jennifer S Gewandter; Nathaniel P Katz; Ernest A Kopecky; John D Markman; George Nomikos; Linda Porter; Bob A Rappaport; Andrew S C Rice; Joseph M Scavone; Joachim Scholz; Lee S Simon; Shannon M Smith; Jeffrey Tobias; Tina Tockarshewsky; Christine Veasley; Mark Versavel; Ajay D Wasan; Warren Wen; David Yarnitsky Journal: Pain Date: 2016-09 Impact factor: 7.926