Stewart M, et al. - Authors sought to obtain current, literature-based estimates of the impact of common pharmacologic treatments on pain reduction in osteoarthritis (OA). In the treatment of OA pain, the effects of 5 major drug categories were reviewed with data extracted from 29 studies published from 2006 to 2016. The RC value of acetaminophen was seen to be close to that of oral NSAIDs. In controlling pain, findings suggested the similarity of the impacts of oral NSAIDs, COX-2 inhibitors, and opioids in controlling pain to what has been demonstrated in the previous literature. Compared to oral NSAIDs, they noted a greater efficacy of topical NSAIDs.

Methods

• Experts conducted a MEDLINE search (2006–2016) for randomized controlled trials studying acetaminophen, oral NSAIDs, topical NSAIDs, COX-2 inhibitors, and opioids in the treatment of OA pain.
• They estimated the drug effect on pain using relative change in pain, and expressed as percentage change.
• For each drug category, an overall effect was obtained as a weighted average of study-specific effects, with weights based on each study’s sample size.

Results

• As per data, 29 studies were included.
• In a total of 43 treatment arms (acetaminophen n=6, oral NSAIDs n=9, topical NSAIDs n=8, COX-2 inhibitors n=9, and opioids n=11), the effect on pain was estimated.
• Results demonstrated the relative (%) changes in pain to be as follows: acetaminophen=32.5, oral NSAIDs=34.3, topical NSAIDs=40.9, COX-2 inhibitors=36.9, and opioids=35.4.