The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
Impact of treatment duration on the effectiveness of opioid analgesia: a systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Froentjes Liesbeth S, Barrington Catherine Am, Craig Rodger A, Morcos Mareiz, Wedman Dawn M, Korowynk Christina S, Kelmer Michael D, Campbell Farah N, Garrison Scott R
Аннотация
BACKGROUND: Opioid use can heighten pain perception over time.
AIM: To determine whether the effectiveness of opioid analgesia diminishes with treatment duration in those with chronic low back pain or osteoarthritis.
DESIGN AND SETTING: Systematic review of randomised trials comparing opioids with placebo/opioid-minimised pain management strategies in those with chronic low back pain or osteoarthritis.
METHOD: A random-effects meta-analysis using MEDLINE, Embase, CENTRAL, and Scopus databases was undertaken in January 2025. The primary outcome was attainment of clinically important pain relief ('moderate' or ≥30% improvement). The secondary outcome was on-treatment pain (100-point scale). The primary analysis was difference in primary/secondary outcomes across short-term (≤4 weeks), intermediate-term (4-12 weeks), and long-term (≥12 weeks) duration subgroups.
RESULTS: In total, 27 trials were eligible for inclusion. Clinically important pain relief differed significantly between short-, intermediate-, and long-term treatment durations (P = 0.05). Opioid recipients were more likely to be responders in short-term trials (eight trials, risk ratio [RR] 1.42, 95% confidence interval [CI] = 1.08 to 1.89, moderate-certainty evidence), but not in intermediate-term trials (three trials, RR 1.04, 95% CI = 0.84 to 1.30, low-certainty evidence), or long-term trials (nine trials, RR 0.91, 95% CI = 0.73 to 1.14, moderate-certainty evidence), which trended in favour of controls. The mean difference in pain scores failed to reach this review's definition of clinical significance (≥10 points) for any timepoint, but was statistically significant in the short and intermediate term.
CONCLUSION: Although opioids likely provide meaningful pain relief over short durations (≤4 weeks), they appear to provide little or no benefit beyond placebo over longer periods, and may worsen pain control beyond 12 weeks.
AIM: To determine whether the effectiveness of opioid analgesia diminishes with treatment duration in those with chronic low back pain or osteoarthritis.
DESIGN AND SETTING: Systematic review of randomised trials comparing opioids with placebo/opioid-minimised pain management strategies in those with chronic low back pain or osteoarthritis.
METHOD: A random-effects meta-analysis using MEDLINE, Embase, CENTRAL, and Scopus databases was undertaken in January 2025. The primary outcome was attainment of clinically important pain relief ('moderate' or ≥30% improvement). The secondary outcome was on-treatment pain (100-point scale). The primary analysis was difference in primary/secondary outcomes across short-term (≤4 weeks), intermediate-term (4-12 weeks), and long-term (≥12 weeks) duration subgroups.
RESULTS: In total, 27 trials were eligible for inclusion. Clinically important pain relief differed significantly between short-, intermediate-, and long-term treatment durations (P = 0.05). Opioid recipients were more likely to be responders in short-term trials (eight trials, risk ratio [RR] 1.42, 95% confidence interval [CI] = 1.08 to 1.89, moderate-certainty evidence), but not in intermediate-term trials (three trials, RR 1.04, 95% CI = 0.84 to 1.30, low-certainty evidence), or long-term trials (nine trials, RR 0.91, 95% CI = 0.73 to 1.14, moderate-certainty evidence), which trended in favour of controls. The mean difference in pain scores failed to reach this review's definition of clinical significance (≥10 points) for any timepoint, but was statistically significant in the short and intermediate term.
CONCLUSION: Although opioids likely provide meaningful pain relief over short durations (≤4 weeks), they appear to provide little or no benefit beyond placebo over longer periods, and may worsen pain control beyond 12 weeks.