Pain practice : the official journal of World Institute of Pain · 2026
Evaluation of the Efficacy of Transdermal Buprenorphine in Chronic Low Back Pain: A Meta-Analysis of Randomized Clinical Trials.
СтатьяМетаанализСистематический обзорНазвание и аннотация: Перевод в очереди
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do Nascimento Souza Anna Karla, Barreto Eduardo Silva Reis, Antunes Júnior César Romero, Piñeiro Gabriel Teles de Oliveira, Kraychete Durval Campos
Аннотация
OBJECTIVE: To evaluate the efficacy of transdermal buprenorphine for treating pain in patients with chronic low back pain (CLBP), with additional assessment of sleep quality and adverse events.
METHODS: A systematic literature search was conducted in PubMed, Scopus, Embase, and Cochrane CENTRAL up to June 2025. Randomized controlled trials (RCTs) comparing transdermal buprenorphine with placebo in adults with CLBP were included. Pain intensity was the primary outcome; secondary outcomes were sleep quality and adverse events. This review followed PRISMA guidelines and was registered in PROSPERO (CRD42024629751).
RESULTS: Six RCTs, including 698 patients, were analyzed. Transdermal buprenorphine did not significantly reduce pain intensity compared to placebo (Mean Difference = -0.32; 95% CI: -1.04 to 0.40; p = 0.380; I2 = 77.4%). However, a small but statistically significant improvement in sleep quality was found (Standardized Mean Difference = -0.24; 95% CI: -0.37 to -0.10; p < 0.001; I2 = 28%). Adverse events were more frequent in the buprenorphine group, although not statistically significant for total adverse events (RR = 1.98; 95% CI: 0.97 to 4.02; p = 0.060).
CONCLUSION: These findings suggest a limited benefit of transdermal buprenorphine for pain relief in CLBP. While sleep quality may improve slightly, the potential for increased adverse events must be considered. Current evidence does not support the routine use of transdermal buprenorphine for CLBP due to insufficient analgesic effect and possible safety concerns.
METHODS: A systematic literature search was conducted in PubMed, Scopus, Embase, and Cochrane CENTRAL up to June 2025. Randomized controlled trials (RCTs) comparing transdermal buprenorphine with placebo in adults with CLBP were included. Pain intensity was the primary outcome; secondary outcomes were sleep quality and adverse events. This review followed PRISMA guidelines and was registered in PROSPERO (CRD42024629751).
RESULTS: Six RCTs, including 698 patients, were analyzed. Transdermal buprenorphine did not significantly reduce pain intensity compared to placebo (Mean Difference = -0.32; 95% CI: -1.04 to 0.40; p = 0.380; I2 = 77.4%). However, a small but statistically significant improvement in sleep quality was found (Standardized Mean Difference = -0.24; 95% CI: -0.37 to -0.10; p < 0.001; I2 = 28%). Adverse events were more frequent in the buprenorphine group, although not statistically significant for total adverse events (RR = 1.98; 95% CI: 0.97 to 4.02; p = 0.060).
CONCLUSION: These findings suggest a limited benefit of transdermal buprenorphine for pain relief in CLBP. While sleep quality may improve slightly, the potential for increased adverse events must be considered. Current evidence does not support the routine use of transdermal buprenorphine for CLBP due to insufficient analgesic effect and possible safety concerns.