• Christopher Eccleston, Emma Fisher, Tess E Cooper, Marie-Claude Grégoire, Lauren C Heathcote, Elliot Krane, Susan M Lord, Navil F Sethna, Anna-Karenia Anderson, Brian Anderson, Jacqueline Clinch, Andrew L Gray, Jeffrey I Gold, Richard F Howard, Gustaf Ljungman, MooreR AndrewRAPain Research, Nuffield, Department of Clinical Neurosciences, University of Oxford, The Churchill, Oxford, United Kingdom., Neil Schechter, Philip J Wiffen, Nick M R Wilkinson, David G Williams, Chantal Wood, van TilburgMiranda A LMALCollege of Pharmacy and Health Sciences, Campbell University, Buies Creek, NC, United States.Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC, United States., and Boris Zernikow.
• Centre for Pain Research, University of Bath, Bath, United Kingdom.
• Pain. 2019 Aug 1; 160 (8): 169817071698-1707.

AbstractWe 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 noncancer pain (CNCP) or chronic cancer-related pain (CCRP). 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 CNCP or CCRP. 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 CNCP or CCRP. Seven of those 23 reviews included 6 trials that involved children with CNCP. There were no randomised controlled trials in reviews relating to reducing pain in CCRP. 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: CRD42018086900.

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