Opioids offer minimal benefit to pain, function in OA, no aid to QoL
Healio Rheumatology highlights the perspective of Allan Gibofsky, MD, rheumatologist at HSS, on study findings published in Arthritis Care & Research showing opioids offer minimal relief of osteoarthritis (OA) symptoms within a 12-week period, and cause discomfort in most patients.
Dr. Gibofsky wrote, “It is generally accepted that the best treatment for end-stage “bone on bone” osteoarthritis of a large joint is arthroplasty. That option, however, may not be appropriate for many patients, especially those with diffuse disease and those with concurrent medical conditions, including hypertensive cardiovascular disease, congestive heart failure and diabetes.” He added, “For that reason, patients who are not candidates for surgery require adequate pain management for their symptoms. Unfortunately, the use of NSAIDs and minor analgesics is usually inadequate, and physicians often find themselves in a position of having to prescribe opioids to these patients.”
Dr. Gibofsky concluded, “In their systematic review, Osani and colleagues found that — when compared to placebo — opioids showed only small benefit to pain and function and contributed no measurable benefit to health-related quality of life, while at the same time showing an increased risk of adverse events. Strong opioids demonstrated consistently inferior efficacy and overall worse safety than weak/intermediate opioids. Given the results of this study, the authors correctly conclude that clinicians and policymakers should reconsider the utility of opioids in the management of OA.
Read the full article at Healio.com/news/rheumatology.