Tramadol and Mortality Among Patients With Osteoarthritis

Tramadol has many drawbacks but is frequently prescribed as a perceived safer agent with less misuse potential.

This cohort study of nearly 89,000 patients aged 50 years and older with osteoarthritis found that initial prescription of tramadol was associated with a significantly higher rate of mortality over 1 year compared with commonly prescribed nonsteroidal anti-inflammatory drugs, but not compared with codeine.

The authors point out the risk of confounding by indication, and further research is needed to determine if this association is causal.

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