Tramadol a popular opioid analgesic was associated with significantly higher all-cause mortality compared with nonsteroidal anti-inflammatory drugs (NSAIDs) among older patients with osteoarthritis (OA). The mortality risk with tramadol was similar to that associated with codeine.
Among patients aged 50 years and older with osteoarthritis, initial prescription of tramadol was associated with a significantly higher rate of mortality over 1 year of follow-up compared with commonly prescribed non steroidal anti-inflammatory drugs, according to Dr. Chao Zeng, MD, PhD, from the Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China, and colleagues.
They noted that guidelines from the American Academy of Orthopaedic Surgeons and the American College of Rheumatology either recommend or conditionally recommend tramadol for the management of knee OA, so these findings might have implications for current clinical practice.
Tramadol has been considered a potential alternative to NSAIDs and traditional opioids because of its assumed relatively lower risk of serious cardiovascular and gastrointestinal adverse effects than NSAIDs, and lower risk of addiction and respiratory depression compared to other opioids.
