University of Toronto, Toronto, Ontario, Canada.
Pain Res Manag. 2010 May-Jun;15(3):147-57. doi: 10.1155/2010/382781.
Neuropathic pain (NP) encompasses many difficult-to-treat disorders. There are few head-to-head, comparative, randomized controlled trials (RCTs) of drugs for NP in different analgesic categories, or of different drugs within a category, despite many placebo-controlled RCTs for individual agents. Well-designed head-to-head comparative trials are an effective way to determine the relative efficacy and safety of a new drug.
To perform a systematic review of head-to-head RCTs of oral analgesics in NP.
A systematic review of RCTs involving NP patients was performed, of which head-to-head comparative trials were selected. Reference lists from published systematic reviews were searched. These studies were rated according to the Jadad scale for quality.
Twenty-seven such trials were identified. Seventeen were comparisons of different analgesics, and 10 were of different drugs within an analgesic class. Important information was obtained about the relative efficacy and safety of drugs in different categories and within a category. Some significant differences between active treatments were reported. Trial inadequacies were identified. More and improved head-to-head RCTs are needed to inform clinical choices.
神经性疼痛（NP）包括许多难以治疗的疾病。尽管有许多针对个别药物的安慰剂对照 RCT，但在不同类别的镇痛药或同一类别内的不同药物之间，几乎没有头对头、比较性、随机对照试验（RCT）。精心设计的头对头比较试验是确定新药相对疗效和安全性的有效方法。
对头对头 RCT 评估治疗神经性疼痛的口服镇痛药进行系统综述。
对涉及 NP 患者的 RCT 进行了系统综述，从中选择了头对头比较试验。从已发表的系统综述的参考文献中进行了检索。这些研究根据 Jadad 量表进行了质量评分。
共确定了 27 项此类试验。其中 17 项为不同镇痛药的比较，10 项为同一镇痛类别的不同药物的比较。获得了有关不同类别和同一类别内药物的相对疗效和安全性的重要信息。报告了一些治疗药物之间的显著差异。发现了试验的不足。需要更多和改进的头对头 RCT 来为临床选择提供信息。
