One of the newer opioids to hit the market has a better pain relief and safety profile in patients with chronic musculoskeletal pain than oxycodone, a Cochrane review finds.

But its overall clinical benefit of in terms of pain reduction is still probably small, say the review authors from the Pain, Palliative and Supportive Care Group.

The review of four trials on the use of  tapentadol extended release (Palexia SR) showed that in comparison to oxycodone, the centrally acting opioid had a 0.24 point reduction in pain intensity from baseline in the 11-point numeric rating scale (NRS).

It was also associated with a 50% risk reduction of discontinuing treatment due to adverse effects (NNTB 6; for 12 weeks), and a 9% reduction in the overall risk of adverse effects (NNTH 18; for 12 weeks).

However while the opioid was associated with a reduction in pain intensity in comparison to placebo and oxycodone the clinical significance of the results was uncertain, the review group said.

This was because of a modest difference between interventions in efficacy outcomes, high heterogeneity in some comparisons and outcomes, high withdrawals rates, and a lack of data for the primary outcome in some studies. 

“For clinicians treating moderate to severe chronic musculoskeletal pain, tapentadol’s safety profile may prove advantageous, while the overall clinical benefit of tapentadol in terms of pain reduction will probably be small,” the review group concluded.