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- Page navigation anchor for RE: Open Access Managing postoperative pain in adult outpatients: a systematic review and meta-analysis comparing codeine with NSAIDsRE: Open Access Managing postoperative pain in adult outpatients: a systematic review and meta-analysis comparing codeine with NSAIDs
"Given how commonly these medications are used, and the uncertainty in their comparative efficacy and safety.." Really?
What about the Cochrane overview [Moore, 2015] or the network meta-analysis [Moore 2018] demonstrating much greater efficacy with ibuprofen than codeine, or a whole range of Cochrane reviews demonstrating this for the individual interventions. Indeed, the Oxford league table goes back over 20 years (http://www.bandolier.org.uk/booth/painpag/Acutrev/Analgesics/lftab.html).
So where is the uncertainty? Indeed, most of the RCTs used date from over 20 years ago, and almost none in the last decade. While I am sure the work is correct, the idea that this is a novel finding, or even needed, is at best odd.
Competing Interests: Within the past 3 years I have provided advice to Biogen on the design of possible trials in painful diabetic neuropathy.References
- Matthew Choi, Li Wang, Christopher J. Coroneos, et al. Managing postoperative pain in adult outpatients: a systematic review and meta-analysis comparing codeine with NSAIDs. CMAJ 2021;193:E895-E905.
- Moore RA, Derry S, Aldington D, Wiffen PJ. Single dose oral analgesics for acute postoperative pain in adults - an overview of Cochrane reviews. Cochrane Database Syst Rev. 2015 Sep 28;2015(9):CD008659. doi: 10.1002/14651858.CD008659.pub3.
- Moore RA, Derry S, Wiffen PJ, Banerjee S, Karan R, Glimm E, Wiksten A, Aldington D, Eccleston C. Estimating relative efficacy in acute postoperative pain: network meta-analysis is consistent with indirect comparison to placebo alone. Pain. 2018 Nov;159(11