Study finds tramadol offers little benefit, higher heart risk
A new meta‑analysis in BMJ Evidence-Based Medicine of 19 randomized trials involving 6,506 adults with chronic pain conditions such as osteoarthritis, low back pain, neuropathic pain and fibromyalgia found that the opioid tramadol produces pain relief below clinically meaningful thresholds while increasing the risk of adverse events, particularly cardiovascular problems like chest pain, coronary artery disease and congestive heart failure. Outside pain specialists said the findings challenge tramadol’s reputation as a safer chronic‑pain opioid and suggest its harms may outweigh its modest benefits, though the authors noted limitations including short trial durations, high risk of bias and lack of head‑to‑head comparisons with other treatments.
📌 Key Facts
- Researchers pooled data from 19 randomized clinical trials including 6,506 adults with various chronic pain conditions.
- Tramadol reduced pain only slightly, with average benefit below established thresholds for clinically important relief compared with placebo.
- Participants taking tramadol had a higher rate of both serious and non‑serious adverse events, with serious harms driven mainly by cardiovascular events such as chest pain, coronary artery disease and congestive heart failure.
- Most trials lasted only 2–16 weeks with 3–15 weeks of follow‑up, and many outcomes showed high risk of bias, limiting conclusions about long‑term safety and effectiveness.
📊 Relevant Data
In the United States, the prevalence of chronic pain among adults aged 50 and older is 37.8%, with Black and Asian older adults less likely to report chronic pain compared to White older adults.
Prevalence and Sociodemographic Correlates of Chronic Pain Among Older U.S. Adults — ScienceDirect
Chronic pain is more prevalent among female respondents, persons with lower educational attainment, non-Hispanic White individuals, and those who are insured in the United States.
Impact of demographic factors on chronic pain among adults in the United States — Wolters Kluwer
Rates of opioid use in the United States are highest among non-Hispanic White patients (12%), followed by non-Hispanic Black patients (11%), and lowest in Asian patients (4%).
Black patients in the United States are more likely than White patients to be prescribed opioid medicines for a long term (47.6% vs. 32%).
Racial disparities in opioid prescription and pain management among breast cancer survivors — Wiley Online Library
Black and Hispanic adults with cardiovascular disease in the United States have significantly higher odds than White adults of reporting poorer perceived health status.