Table 3.
Opioids, paracetamol, and topical placebo effect estimates for pain and dropouts due to adverse events compared with oral placebo
| Drugs | Pain | Dropouts due to adverse events, odds ratio (95% Crl) | |
|---|---|---|---|
| Effect size (95% Crl) | Probability of MID | ||
| Opioids | |||
| Buprenorphine sublingual 0.87 mg | −0.35 (−1.39 to 0.69) | 48.7 | 2.88 (1.19 to 6.88) |
| Buprenorphine transdermal 0.28-0.36 mg | −0.36 (−0.73 to 0.01) | 47.9 | 2.07 (1.19 to 3.61) |
| Codeine 105-127 mg | −0.19 (−0.62 to 0.24) | 19.9 | 1.51 (0.81 to 2.85) |
| Dextropropoxyphene 300 mg | — | — | 1.02 (0.43 to 2.34) |
| Fentanyl transdermal 0.6 mg | −0.31 (−0.69 to 0.07) | 37.6 | 2.76 (1.22 to 6.32) |
| Hydromorphone 8 mg | −0.01 (−0.53 to 0.50) | 8.7 | 4.93 (2.68 to 9.27) |
| Hydromorphone 13.9-16 mg | −0.16 (−0.51 to 0.18) | 12.0 | 8.72 (5.10 to 15.09) |
| Hydromorphone 34 mg | −0.00 (−0.61 to 0.60) | 11.6 | — |
| Morphine with naltrexone 43.5 mg | −0.25 (−0.82 to 0.32) | 34.1 | 1.46 (0.62 to 3.52) |
| Oxycodone ≤40 mg | −0.09 (−0.41 to 0.22) | 4.5 | 7.29 (4.83 to 11.17) |
| Oxycodone ≥48 mg | −0.17 (−0.33 to −0.01) | 0.9 | 6.78 (4.70 to 9.66) |
| Oxymorphone 40 mg | −0.23 (−0.77 to 0.30) | 31.1 | 13.26 (6.53 to 27.94) |
| Oxymorphone 80 mg | −0.32 (−0.86 to 0.22) | 42.3 | 19.34 (9.47 to 40.29) |
| Tapentadol <316 mg | −0.34 (−0.50 to −0.17) | 33.9 | 2.58 (1.84 to 3.67) |
| Tramadol 100-131 mg | −0.12 (−0.25 to 0.01) | 0.0 | 1.77 (1.25 to 2.51) |
| Tramadol 200 mg | −0.13 (−0.26 to 0.00) | 0.0 | 2.86 (2.10 to 3.89) |
| Tramadol 275-300 mg | −0.31 (−0.43 to −0.20) | 18.1 | 4.73 (3.52 to 6.39) |
| Tramadol 400 mg* | −0.23 (−0.46 to −0.01) | 11.8 | 4.71 (2.75 to 8.02) |
| Tramadol with paracetamol 154-225 mg | −0.39 (−0.88 to 0.09) | 53.0 | 3.17 (1.55 to 6.84) |
| Paracetamol | |||
| Paracetamol <2000 mg | −0.07 (−0.56 to 0.44) | 11.8 | 1.51 (0.58 to 3.72) |
| Paracetamol 3000 mg | −0.21 (−0.81 to 0.39) | 29.7 | 1.31 (0.56 to 3.12) |
| Paracetamol 3900-4000 mg* | −0.15 (−0.25 to −0.05) | 0.0 | 1.35 (1.00 to 1.81) |
| Placebo | |||
| Placebo topical | −0.23 (−0.39 to −0.06) | 4.6 | 0.84 (0.55 to 1.27) |
| Placebo oral and topical | 0.07 (−0.22 to 0.35) | 0.2 | 1.20 (0.56 to 2.52) |
CrI=credible interval; MID=between group minimum clinically important difference; NSAID=non-steroidal anti-inflammatory drug.
All treatment effect estimates are comparisons to oral placebo. Number of participants randomised to oral placebo: 18 712. All doses are in mg per day. The lower bound of the 95% CrI of dropouts due to adverse events for paracetamol 3900-4000 mg is >1, but is shown as 1.00 due to rounding. Pain: 84 of 93 interventions or controls included, 170 of 192 trials with available data; dropouts due to adverse events: 86 of 93 interventions or controls included, 168 of 192 trials with data available.
Maximum daily recommended dose.
Withdrawn from market.