Is Tramadol safe and effective for the treatment of osteoarthritis?

BEEM Bottom Line

Why is this study important?

Acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids are the primary 3 options for the treatment of osteoarthritic pain. Acetaminophen is the safest but least effective. NSAIDs, including cox-2 inhibitors, have been linked to adverse gastrointestinal, renal, and cardiovascular effects. Opioids are associated with increased tolerance, dependence and respiratory depression. The American College of Rheumatology (ACR), the Osteoarthritis Research Society International (OARSI) recommend tramadol, an opioid and serotonin-norepinephrine reuptake inhibitor (SNRI) in managing OA pain because it has fewer adverse effects than NSAIDs.[1] [2]

Which, if any, threats to validity are most likely to have an impact on the results and how?

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