Combination drug therapy for the management of low back pain and sciatica: systematic review and meta-analysis

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dc.creatorStephanie Mathieson
dc.creatorRichard Kasch
dc.creatorChristopher Maher
dc.creatorRafael Zambelli de Almeida Pinto
dc.creatorAndrew McLachlan
dc.creatorBart Koes
dc.creatorChung-Wei Christine Lin
dc.date.accessioned2022-07-15T13:41:08Z
dc.date.accessioned2025-09-09T00:08:18Z
dc.date.available2022-07-15T13:41:08Z
dc.date.issued2019-01
dc.identifier.doihttps://doi.org/10.1016/j.jpain.2018.06.005
dc.identifier.issn1526-5900
dc.identifier.urihttps://hdl.handle.net/1843/43307
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofJournal of Pain
dc.rightsAcesso Restrito
dc.subjectDor nas costas
dc.subjectAnalgésicos
dc.subjectCiática
dc.subjectRevisão sistemática
dc.subjectMedicamentos
dc.subject.otherBack pain
dc.subject.otherAnalgesics
dc.subject.othersciatica
dc.subject.othersystematic review
dc.subject.othermedicine
dc.titleCombination drug therapy for the management of low back pain and sciatica: systematic review and meta-analysis
dc.typeArtigo de periódico
local.citation.epage15
local.citation.issue1
local.citation.spage1
local.citation.volume20
local.description.resumoCombining medicines may give greater pain relief and/or improved tolerability. We conducted a systematic review to investigate the effects of combination drug therapy in patients with low back pain and/or sciatica on pain, disability, and adverse events. Databases and trial registers were searched from inception to July 27, 2017, for randomized trials of (sub)acute or chronic back pain or sciatica participants that were administered combination drug therapy compared with monotherapy or placebo. Of the 27 studies included, most combinations (21 of 23) consisted of single trials. Most combinations had no or small effect on pain and disability. A clinically important difference was found in one combination, buprenorphine plus pregabalin versus buprenorphine for chronic back pain at immediate (mean difference = –23.30; 95% confidence interval = –27.68 to –18.92) and short (mean difference = –27.60; 95% confidence interval = –31.70 to –23.50) terms; however, the quality of evidence was low. There was no statistically significant increased risk of serious adverse events. When the risk of adverse events was statistically significant, it favored monotherapy or placebo. There is no clear evidence to support any combination drug therapy for the management of low back pain and sciatica due to the limited number of studies and overall low quality of evidence. Perspective: Combining medicines may give greater pain relief and/or improved tolerability compared with single-ingredient medicines. However, the lack of studies and overall low quality of evidence limit the recommendation of combination drug therapy for the management of low back pain and sciatica.
local.identifier.orcidhttps://orcid.org/ 0000-0002-7335-8842
local.identifier.orcidhttps://orcid.org/ 0000-0002-1628-7857
local.identifier.orcidhttps://orcid.org/0000-0002-2775-860X
local.identifier.orcidhttps://orcid.org/ 0000-0003-4674-0242
local.identifier.orcidhttps://orcid.org/ 0000-0002-0450-9969
local.identifier.orcidhttps://orcid.org/ 0000-0001-6192-7238
local.publisher.countryBrasil
local.publisher.departmentEEF - DEPARTAMENTO DE FISIOTERAPIA
local.publisher.initialsUFMG
local.url.externahttps://www.sciencedirect.com/science/article/pii/S1526590018303195?via%3Dihub#!

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