Comparative Efficacy of Non-opioid Analgesic Drugs for Chronic Cancer Pain: A Bayesian Network Meta-analysis.
DrugsJul 9, 2026 (epub)
Sebastiano Mercadante, Giovanbattista Vizzini, Alessio Lo Cascio
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In 30 seconds
This Bayesian network meta-analysis evaluated the efficacy of non-opioid analgesics for chronic cancer pain in 1845 patients across 23 randomized controlled trials. The study found that nonsteroidal anti-inflammatory drugs (NSAIDs) and anticonvulsants had the strongest analgesic effects, with a significant opioid-sparing effect observed for gabapentinoids and ketamine.
Key findings
- NSAIDs and anticonvulsants showed the most robust analgesic effects with standardized mean differences of -1.10 and -1.06, respectively.
- The combination of anticonvulsants and antidepressants had the highest probability of efficacy according to SUCRA rankings.
- Gabapentinoids and ketamine facilitated a significant reduction in morphine equivalent daily dose (MEDD).
- Minor adverse events like somnolence and dizziness were more frequent in the most effective drug classes.
Why it matters
The findings highlight the potential of non-opioid analgesics to effectively manage chronic cancer pain while minimizing opioid-related toxicities, which is crucial for improving patient quality of life.