Table 32GRADE profiles – nortriptyline vs gabapentin as monotherapy

No. of studiesDesignNort
(T1)
Gaba
(T2)
Relative risk (95% CI)
[ARR]
[NNTB, 95% CI]
LimitationsInconsistencyIndirectnessImprecisionOther considerationsQuality
PRIMARY OUTCOME: Patient-reported 50% pain reduction
1
(PHN1)
RCT9/36
(25.0%)
7/34
(20.6%)
1.21 (0.51, 2.90)
ARR = 4.4%
NNTB = N/A
NNNSaNModerate
No. of studiesDesignNortripGabaRelative risk (95% CI)
[ARI]
[NNTH, 95% CI]
LimitationsInconsistencyIndirectnessImprecisionOther considerationsQuality
PRIMARY OUTCOME: Somnolence (adverse effects)
1
(PHN1)
RCT6/36
(16.7%)
4/34
(11.8%)
1.42 (0.44, 4.59)
ARI = 4.9%
NNTH = N/A
NNNVSbNVery low
PRIMARY OUTCOME: Dry mouth (adverse effects)
1
(PHN1)
RCT18/36
(50.0%)
0/34
(0.0%)
∞ (∞)
ARI = 50.0%
NNTH = N/A
NNNVSbNVery low
PRIMARY OUTCOME: Fatigue (adverse effects)
1
(PHN1)
RCT0/36
(0.0%)
1/34
(2.9%)
0.00 (0.00, ∞)
ARI = −2.9%
NNTH = N/A
NNNVSbNVery low

Relative risks were calculated in the direction of T1 compared with T2.

T1 = treatment 1; T2 = treatment 2; N = No serious; S = Serious; VS = Very serious

Nort = nortriptyline; Gaba = gabapentin; PHN = post-herpetic neuralgia; N/A = not applicable.

a

Total number of events (positive outcome) less than 300.

b

GDG consensus: if there is only 1 study with total number of adverse effects less than 100, the GDG decided that the quality should be graded as ‘very low’.

1

Chandra et al. (2006)

Total number of events (positive outcome) less than 300.

GDG consensus: if there is only 1 study with total number of adverse effects less than 100, the GDG decided that the quality should be graded as ‘very low’.

From: 2, How this guideline was developed

Cover of Neuropathic Pain
Neuropathic Pain: The Pharmacological Management of Neuropathic Pain in Adults in Non-Specialist Settings.
NICE Clinical Guidelines, No. 96.
Centre for Clinical Practice at NICE (UK).
Copyright © 2010, National Institute for Health and Clinical Excellence.

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