caa a22 4500 445831154 CHVBK 20180317145315.0 cr unu---uuuuu 170323e20110101xx s 000 0 eng 10.1007/s00586-010-1541-4 doi (NATIONALLICENCE)springer-10.1007/s00586-010-1541-4 A systematic review on the effectiveness of pharmacological interventions for chronic non-specific low-back pain [Elektronische Daten] [T. Kuijpers, M. van Middelkoop, S. Rubinstein, R. Ostelo, A. Verhagen, B. Koes, M. van Tulder] The objective of this review was to determine the effectiveness of pharmacological interventions [i.e., non-steroid anti-inflammatory drugs (NSAIDs), muscle relaxants, antidepressants, and opioids] for non-specific chronic low-back pain (LBP). Existing Cochrane reviews for the four interventions were screened for studies fulfilling the inclusion criteria. Then, the literature searches were updated. Only randomized controlled trials on adults (≥18years) with chronic (≥12weeks) non-specific LBP and evaluation of at least one of the main clinically relevant outcome measures (pain, functional status, perceived recovery, or return to work) were included. The GRADE approach was used to determine the quality of evidence. A total of 17 randomized controlled trials was included: NSAIDs (n=4), antidepressants (n=5), and opioids (n=8). No studies were found for muscle relaxants; 14 studies had a low risk of bias. The studies only reported effects on the short term (<3months). The overall quality of the evidence was low. NSAIDs and opioids seem to lead to a somewhat higher relief in pain on the short term, as compared to placebo, in patients with non-specific chronic low back pain; opioids seem to have a small effect in improving function for a selection of patients who responded with an exacerbation of their symptoms after stopping their medication. However, both types of medication show more adverse effects than placebo. There seems to be no difference in effect between antidepressants and placebo in patients with non-specific chronic LBP. The Author(s), 2010 Systematic review nationallicence Medication nationallicence Pharmacological interventions nationallicence Low-back pain nationallicence Interventions nationallicence Kuijpers T. Dutch Institute for Health Care Improvement CBO, Churchilllaan 11, P.O. Box 20064, 3502 LB, Utrecht, The Netherlands aut van Middelkoop M. Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands aut Rubinstein S. EMGO-Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands aut Ostelo R. EMGO-Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands aut Verhagen A. Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands aut Koes B. Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands aut van Tulder M. EMGO-Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands aut European Spine Journal Springer-Verlag 20/1(2011-01-01), 40-50 0940-6719 20:1<40 2011 20 586 https://doi.org/10.1007/s00586-010-1541-4 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-010-1541-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kuijpers T. Dutch Institute for Health Care Improvement CBO, Churchilllaan 11, P.O. Box 20064, 3502 LB, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- van Middelkoop M. Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- Rubinstein S. EMGO-Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- Ostelo R. EMGO-Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- Verhagen A. Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- Koes B. Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- van Tulder M. EMGO-Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20/1(2011-01-01), 40-50 0940-6719 20:1<40 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer