12 Nov Researchers Question Value of Opioids in Osteoarthritis Treatment
MedicalResearch.com Interview with:
Raveendhara R. Bannuru MD, PhD, FAGE
Director, Center for Treatment Comparison and Integrative Analysis (CTCIA)
Deputy Director, Center for Complementary and Integrative Medicine (CCIM)
Asst Professor of Medicine, Tufts University School of Medicine
Asst Professor of Clinical & Translational Science, Sackler School of Graduate Biomedical Sciences
Division of Rheumatology, Tufts Medical Center
MedicalResearch.com: What is the background for this study?
Response: Given the current controversy regarding the use of opioids in chronic pain, we wanted to delve deeper into the efficacy and safety profiles of oral opioid drugs in osteoarthritis patients. Temporal assessments like ours can reveal peak periods of efficacy, and can provide clinicians with a blueprint for optimal durations of treatment regimens. With respect to subgroup analyses based on strength of opioid binding affinity, we sought to explore currently held paradigms that strong opioids may be useful for the treatment of severe pain, and to specifically assess their relevance in OA populations. Knowledge of the relative efficacy and safety profiles of strong versus weak opioids can give clinicians the information they need to weigh benefits and harms of specific subgroups of opioids.
MedicalResearch.com: What are the main findings?
Response: Overall opioids demonstrated only small effects on pain and function that did not “peak” at any point over the 12-week period assessed. Conversely, participants who received opioids were significantly more likely to experience adverse events leading to discontinuation or discomfort. One of the most interesting findings from our study is the underperformance of strong opioids. The most likely explanation for this could be the relationship between pain relief and the tolerability of opioids based on dose.
MedicalResearch.com: What should readers take away from your report?
Response: In light of these results, and in the context of a rapidly shifting paradigm for pain management, clinicians and policy makers should reconsider the utility of opioids in the management of osteoarthritis.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Future research may focus on qualitative assessments of patient preference and experience with opioid treatment, to garner a holistic understanding of their impact on patients’ daily lives. More nuanced responder analyses may also provide valuable information about patient populations that could still benefit from the use of these drugs.
2019 ACR/ARP presentation:
Is There Any Role for Opioids in the Management of OA?
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