Tramadol tied to higher mortality rates than NSAIDs in osteoarthritis patients


Tramadol tied to higher mortality rates than NSAIDs in osteoarthritis patients


A new study has shown that patients with osteoarthritis (OA) who were treated with tramadol had a significantly higher mortality risk during the first year of treatment when compared with patients treated with non-steroidal anti-inflammatory drugs (NSAIDs).

They also found that tramadol users had a higher risk of cardiovascular disease, venous thromboembolism, and hip fractures than NSAID users.

Although the mortality risk of the use of tramadol has been highlighted previously, the risk comparison between tramadol and NSAIDs has previously been inconclusive.

In the present study, the team compared data from patients who received a first prescription of tramadol, naproxen, diclofenac, cyclooxygenase-2 (COX-2) inhibitors, or codeine.

At the patients’ one year follow-up, it was found that tramadol users had a higher mortality risk than users of naproxen, diclofenac, and COX-2 inhibitors, but not higher than codeine users.

Tramadol users were also found to be at a higher risk of cardiovascular disease  and venous thromboembolism than users of diclofenac and COX-2 inhibitors, and a higher risk of hip fractures than users of naproxen, diclofenac, and COX-2 inhibitors.

Regarding the study, Thomas Schwenk, MD, from the University of Nevada, Reno, said: "Tramadol might be an option for patients in whom NSAIDs are contraindicated, but it should be prescribed as judiciously as traditional opioids."



Li L et al. Association of tramadol with all-cause mortality, cardiovascular disease, venous thromboembolism and hip fractures among patients with osteoarthritis. A population-based study. Abstract OP0191. Presented at the European League Against Rheumatism (EULAR) 2020 Congress on June 4, 2020.

MDedge. Tramadol mortality risk in osteoarthritis could outweigh benefits. 5 June 2020.

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