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Papers of the Week

Papers: 18 May 2019 - 24 May 2019

Pharmacology/Drug Development

2019 Jun 19


Pharmacological interventions for chronic pain in children: an overview of systematic reviews.


Eccleston C, Fisher E, Cooper TE, Grégoire M-C, Heathcote LC, Krane E, Lord SM, Sethna NF, Anderson A-K, Anderson B, Clinch J, Gray AL, Gold JI, Howard RF, Ljungman G, Moore AR, Schechter N, Wiffen PJ, Wilkinson N M, Williams DG, et al.
Pain. 2019 Jun 19.
PMID: 31107413.


We know little about the safety or efficacy of pharmacological medicines for children and adolescents with chronic pain, despite their common use. Our aim was to conduct an overview review of systematic reviews of pharmacological interventions that purport to reduce pain in children with chronic non-cancer pain or chronic cancer-related pain. We searched the Cochrane Database of Systematic Reviews, Medline, EMBASE and DARE for systematic reviews from inception to March 2018. We conducted reference and citation searches of included reviews. We included children (0-18 years of age) with chronic non-cancer pain or chronic cancer-related pain. We extracted the review characteristics and primary outcomes of ≥30% participant-reported pain relief and patient global impression of change. We sifted 704 abstracts and included 23 systematic reviews investigating children with chronic non-cancer pain or chronic cancer-related pain. Seven of those 23 reviews included six trials that involved children with chronic non-cancer pain. There were no RCTs in reviews relating to reducing pain in chronic cancer-related pain. We were unable to combine data in a meta-analysis. Overall, the quality of evidence was very low and we have very little confidence in the effect estimates. The state of evidence of randomized controlled trials in this field is poor; we have no evidence from randomised controlled trials for pharmacological interventions in children with cancer-related pain, yet cannot deny individual children access to potential pain relief. Prospero ID: CRD42017081205. A video accompanying this abstract is available online as Supplemental Digital Content at http://links.lww.com/PAIN/A797.