. 2023 May 10;2023(5):CD014682. doi: 10.1002/14651858.CD014682.pub2

10. Moderate pain summary of findings.

Estimates of effects, credible intervals, and certainty of the evidence for moderate pain relief in people with chronic pain
Bayesian network meta‐analysis summary of findings table
Patient or population: people with chronic pain Interventions: mirtazapine, duloxetine, milnacipran. all doses were combined for each antidepressant. Comparator (reference): placebo Outcome: moderate pain relief (defined as 30% reduction in pain intensity from baseline to post‐intervention; measured on a range of scales including 0‐10 VAS, 0‐100 VAS, and hort‐form McGill Pain Questionnaire Direction: Higher is better (i.e. more people reporting moderate pain relief)
Total studies: 40 Total participants: 14,208	Relative effect (OR and 95% CI)	Anticipated absolute effect (event rate)*			Certainty of the evidence (CINeMA)	Ranking (2.5% to 97.5% credible interval)**	Interpretation of findings
Total studies: 40 Total participants: 14,208	Relative effect (OR and 95% CI)	With placebo	With intervention	Difference	Certainty of the evidence (CINeMA)	Ranking (2.5% to 97.5% credible interval)**	Interpretation of findings
Mirtazapine RCTs: 2 Participants: 462	1.92 (1.45 to 2.39)	70/224 313 per 1000	112/238 466 per 1000	154 more per 1000	Low^e	7 (3 to 13)	Equivalent NNTB is 6.5
Duloxetine RCTs: 24 Participants: 7833	1.79 (1.67 to 1.91)	1324/3271 405 per 1000	2469/4562 549 per 1000	144 more per 1000	Moderate^a	7 (4 to 11)	Equivalent NNTB is 6.9
Milnacipran RCTs: 7 Participants: 3056	1.7 (1.48 to 1.92)	347/1128 308 per 1000	825/1928 430 per 1000	123 more per 1000	Moderate^a	8 (4 to 12)	Equivalent NNTB is 8.1
Esreboxetine RCTs: 2 Participants: 1374	1.65 (1.32 to 1.98)	107/409 262 per 1000	356/965 369 per 1000	107 more per 1000	Low^a,e	9 (4 to 13)	Equivalent NNTB is 9.3
Network meta‐analysis‐summary of findings table definitions * Anticipated absolute effect. Anticipated absolute effect compares two risks by calculating the difference between the risk of the intervention group with the risk of the control group. Mean rank and credible intervals are presented. CI: confidence interval; CINeMA: Confidence in Network Meta‐Analysis; NNTB: number needed to treat for an additional beneficial outcome; OR: odds ratio; RCT: randomised controlled trial; VAS:** visual analogue scale The number of participants for each antidepressant reflects the total number of participants taking the antidepressant or placebo from the studies in the network meta‐analysis.
CINeMA grades of confidence in the evidence High: further research is unlikely to change our confidence in the estimate of effect. Moderate: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low: we are very uncertain about the estimate.

^aDowngraded due to within‐study bias. ^bDowngraded due to imprecision in the estimate. ^cDowngraded due to heterogeneity in the estimate. ^dDowngraded due to incoherence in the network. ^eDowngraded due to a small number of trials and participants; we cannot draw reliable conclusions.