OBJECTIVES: Chronic Low back pain (CLBP) is a highly prevalent group of disabling musculoskeletal disorder and Majority are treated with anti-depressants and opioids. The objective of this study is to comprehensively assess the efficacy and safety of opioids in CLBP patients by network meta-analysis (NMA).

METHODS

: Search strategy: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) and MEDLINE (1966 to October 2017). We contacted investigators for incomplete data.

Selection criteria: We included randomized controlled trials (RCTs) comparing efficacy (30% and 50% pain reduction) safety (total withdrawal from clinical trial) of opioid analgesics in patients with CLBP

Data collection and analysis: Two authors independently assessed the studies for inclusion and undertook methodological quality assessment and data abstraction. Effect estimates were reported as relative risk (RR) along with 95% confidence interval (CI). Inconsistency and heterogeneity between and within the loops were assessed. P-scores were used to rank order the treatments. We performed NMA as per frequentist method by using R 3.3.2.

RESULTS

: CONCLUSIONS

: Among eight opioid interventions compared, Buprenorphine and Hydromorhone were found to be most effective interventions in CLBP patients.