Meta-Analysis with Meta-Regression and Systematic Review of the Efficacy of On-Demand Tramadol for the Treatment of Lifelong Premature Ejaculation
Abstract
This is a systematic review and meta-analysis on the efficacy of on demand tramadol for the treatment of lifelong premature ejaculation. Methods: A systematic review and meta-analysis with meta regression of trials evaluating the use of tramadol to treat premature ejaculation using intravaginal ejaculation latency time as a measure. Relevant studies were identified using PubMed, Ebscohost, MEDLINE, EMBASE and the Cochrane Collaboration Library. Results: This analysis included 8 publications. Study of the intravaginal ejaculation latency time (IELT) among 599 patients showed that tramadol was effective in subjects with premature ejaculation as seen by the significant difference in mean IELT of tramadol treated patients versus those receiving placebo (mean difference 2.43 minutes; 95% CI 0.93-3.93; P=0.002). The effect on IELT between tramadol and paroxetine was not statistically significant (mean difference -0.58; 95% CI -5.81 to 4.65; P=0.83). Meta-regression analysis showed that the lower the dose of tramadol, the higher its benefit in the prolongation of IELT, however, there was no significant difference (95% CI regression coefficient -0.0956 to 0.0322). There was a significant difference in adverse effects profile of tramadol versus placebo (risk ratio 2.48; 95% CI 1.55-3.98; overall effect Z= 3.79; P< 0.0002) and overall therapeutic effectiveness between tramadol compared to placebo (risk ratio 0.55; 95% CI 0.46- 0.67; P< 0.00001). Conclusion: On-demand tramadol is an…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 599 participants or records.
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