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Study: Paracetamol not efficacious for treatment of osteoarthritis pain
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According to researchers, paracetamol is not effective for the treatment of osteoarthritis pain regardless of dose, and patients responded more favorably to treatment with 150-mg diclofenac.
Researchers analyzed the Cochrane Central Register of Controlled Trials (CENTRAL) for data published from osteoarthritis (OA) trials between Jan. 1, 1980 and Feb. 24, 2015. Seventy-four trials were identified that included data on the use of paracetamol/acetaminophen and included a total of 58,556 patients with OA. Celecoxib and naproxen were the most commonly medications also studied. The trials were deemed to have a low risk for bias.
Analysis showed regardless of dose, improvement of OA pain based on the WOMAC and other scoring systems was apparent in all interventions compared to placebo in pooled data. However, only 150-mg diclofenac and 60-mg etoricoxib had a 100% probability to meet a minimum clinically important difference. Linear dose effects were only demonstrated in trials with diclofenac, celecoxib and naproxen.
Effect sizes in 20 of 21 studies suggested physical function was only improved with etoricoxib, but not enough evidence of superiority was demonstrated in six studies that included 2,000- to 3,000-mg paracetamol, 50-mg rofecoxib, 70-mg diclofenac, 750-mg naproxen and 1,200-mg ibuprofen.
“NSAIDs are usually only used to treat short-term episodes of pain in osteoarthritis, because the side-effects are thought to outweigh the benefits when used longer term,” study coauthor Sven Trelle, MD, from the University of Bern, Bern Switzerland, said in a press release from The Lancet. “Because of this, paracetamol is often prescribed to manage long-term pain instead of NSAIDs. However, our results suggest that paracetamol at any dose is not effective in managing pain in osteoarthritis, but that certain NSAIDs are effective and can be used intermittently without paracetamol.” – by Shirley Pulawski
Disclosure s : da Costa reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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