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ACR: Opioids Offer Only Minor Pain Relief in Osteoarthritis

Last Updated: November 12, 2019.

Opioids offer minor pain relief and functional benefits in patients with osteoarthritis, with smaller benefits regarding pain for strong versus weak opioids, according to research presented at the annual meeting of the American College of Rheumatology, held from Nov. 8 to 13 in Atlanta.

TUESDAY, Nov. 12, 2019 (HealthDay News) -- Opioids offer minor pain relief and functional benefits in patients with osteoarthritis (OA), with smaller benefits regarding pain for strong versus weak opioids, according to research presented at the annual meeting of the American College of Rheumatology, held from Nov. 8 to 13 in Atlanta.

Raveendhara R. Bannuru, M.D., Ph.D., from the Center for Treatment Comparison and Integrative Analysis at Tufts Medical Center in Boston, and colleagues conducted meta-analyses of pain and function at two, four, eight, and 12 weeks and examined relevant safety outcomes for opioids among patients with knee and/or hip OA. Data were included from 23 randomized controlled trials involving 11,402 participants.

The researchers found that at each time point, opioids demonstrated small, statistically significant benefits for pain, ranging from −0.28 to −0.19; small, statistically significant effects were also seen with respect to function at all time points, ranging from −0.26 to −0.16. No impact on quality of life or depression was observed for opioids; significantly higher quality of sleep was reported for participants receiving opioids. Consistently smaller benefits regarding pain were seen for strong versus weak opioids. Opioid dosage had no impact on pain relief in meta-regression. The safety profile was consistently worse for strong versus weak opioids, particularly with respect to drug withdrawal symptoms (2.78 versus 1.06) and discontinuation due to adverse events (5.47 versus 2.77).

"Strong opioids' underperformance was the study's most interesting finding, and likely due to the relationship between pain relief and tolerability of opioids based on dose," Bannuru said in a statement.

One author disclosed financial ties to the pharmaceutical industry.

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