Opioid use in knee or hip osteoarthritis: a region-wide population-based cohort study

Thorlund, Jonas Bloch; Turkiewicz, Aleksandra; Prieto-Alhambra, Daniel; Englund, Martin

doi:10.1016/j.joca.2019.01.005

Cited by 55 publications

(42 citation statements)

References 32 publications

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“…Of the 27,513 patients who attended GLA: D, 24 Participants were characterized as having hip or knee OA based on their primary concern. However, 2441 (40.44%) of 6036 hip OA participants also had knee OA, and 3620 (20.34%) of 17,795 knee OA participants also had hip OA.…”

Section: Resultsmentioning

confidence: 99%

“…As the number of comorbidities increases so does the use of pain medication, this itself is not surprising, there is, however, a potential cause for concern in the rapid increase in opioid usage from 4.6% to 19.5% going from 0 to 4þ comorbidities, considering the recent focus of opioid overuse, 23 with further suggestion that there is considerable use in an OA setting. 24 This raises long-term concerns especially when the analgesic effects of physical activity are so widely known. 25,26 Physical activity and function with long-term health conditions.…”

Section: Discussionmentioning

confidence: 99%

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Comorbidities and their link with individual health status: A cross-sectional analysis of 23,892 people with knee and hip osteoarthritis from primary care

et al. 2020

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Objectives: Robust data on the impact of comorbidities on health in people with osteoarthritis (OA) are lacking, despite its potential importance for patient management. Objectives were to determine coexisting conditions in people with OA in primary care and whether more comorbidities were linked with individual health status. Methods: A retrospective analysis of 23,892 patients with knee and hip OA was conducted to determine comorbidities present (number/clusters) and how these linked with pain intensity (0–100), widespread pain (site numbers), medication usage (paracetamol, nonsteroidal anti-inflammatory drugs, opioids), quality of life EuroQol five dimension scale (EQ-5D), and physical function (walking speed) using independent t-tests or χ 2 test. Results: Sixty-two percent of people with OA treated in primary care had at least one comorbidity; hypertension (37%), heart disease (8%), and diabetes (7%) being most common. Outcome measures worsened with more comorbidities (0–4+ comorbidities); pain intensity [mean (SD)] 46(22)–57(21); number of painful sites 3.7(3.0)–6.3(5.4); quality of life 0.73(0.10)–0.63(0.15); walking speed 1.57 m/s (0.33)–1.24 m/s (0.31), while the proportion of people using pain medication increased from 0 to 2 comorbidities (58–69%; p < 0.001), with an increase in opioid use from 4.6% to 19.5% with more comorbidities (0–4+ comorbidities). Conclusion: Most people with knee or hip OA in primary care have at least one other long-term condition. A greater number of comorbidities is linked with worsening health, highlighting the importance of screening for comorbidities when treating patients with OA. It is important for clinicians to consider how OA treatments will interact and affect other common comorbidities.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comorbidities and their link with individual health status: A cross-sectional analysis of 23,892 people with knee and hip osteoarthritis from primary care

et al. 2020

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“…A recent report showed that nearly 10% of all opioids prescribed in Australian general practice are prescribed for OA [4]. Similarly, in a survey of Swedish residents aged ≥35 years, 12% of incident opioid dispensations were attributable to OA and/or its related comorbidities [5]. Although there is inconclusive evidence for the benefits of opioids for arthritides and increasing awareness of the risks, opioid prescription rates for OA in the USA remained stable between 2007 and 2014 [6].…”

Section: Introductionmentioning

confidence: 99%

Understanding the Molecular Mechanisms Underlying the Pathogenesis of Arthritis Pain Using Animal Models

Hong

Park

Kim

2020

IJMS

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Arthritis, including osteoarthritis (OA) and rheumatoid arthritis (RA), is the leading cause of years lived with disability (YLD) worldwide. Although pain is the cardinal symptom of arthritis, which is directly related to function and quality of life, the elucidation of the mechanism underlying the pathogenesis of pain in arthritis has lagged behind other areas, such as inflammation control and regulation of autoimmunity. The lack of therapeutics for optimal pain management is partially responsible for the current epidemic of opioid and narcotic abuse. Recent advances in animal experimentation and molecular biology have led to significant progress in our understanding of arthritis pain. Despite the inherent problems in the extrapolation of data gained from animal pain studies to arthritis in human patients, the critical assessment of molecular mediators and translational studies would help to define the relevance of novel therapeutic targets for the treatment of arthritis pain. This review discusses biological and molecular mechanisms underlying the pathogenesis of arthritis pain determined in animal models of OA and RA, along with the methodologies used.

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“…However, little is known about the pathogenesis of OA pain, and thus, there is a lack of targeted treatment and measures to control OA pain. Nonsteroidal anti-inflammatory drugs [3,4] and opioids [5,6] have a certain effect on relieving OA pain, but longterm use of these drugs has great side effects, and they cannot fundamentally reverse or delay the progression of the disease [7][8][9][10]. Although surgery is effective in relieving pain in patients with advanced OA, surgery itself can cause pain and increase the financial burden on the patient.…”

Section: Introductionmentioning

confidence: 99%

Relationship between Pain Behavior and Changes in KCNA2 Expression in the Dorsal Root Ganglia of Rats with Osteoarthritis

Zhao

Fan

Wang

et al. 2020

Pain Research and Management

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Objective. To investigate the relationship between pain behavior and potassium voltage-gated channel subfamily A member 2 (KCNA2) expression in dorsal root ganglia (DRGs) of rats with osteoarthritis (OA). Methods. Male Sprague-Dawley rats were randomly divided into three groups: blank control group (group C), normal saline group (group S), and group OA. Paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) were measured one day before injection and one, two, four, and six weeks after injection. At one, two, four, and six weeks after injection, pathological knee joint changes and activated transcription factor-3 (ATF-3) and KCNA2 expressions in DRGs were analyzed. Results. Compared with preinjection, PWMT and PWTL at two, four, and six weeks after injection were significantly decreased in the group OA (P<0.05 or 0.01). Compared with group C, PWMT and PWTL at two, four, and six weeks after injection were significantly decreased in the group OA (P<0.05 or 0.01). In the group OA, slight local articular cartilage surface destruction was found at week one. The cartilage surface destruction gradually developed, and the exacerbation of cartilage matrix reduction and bone hyperplasia were increasingly aggravated and eventually evolved into advanced OA in the second to sixth weeks. Compared with group C, ATF-3 expression was significantly increased, and KCNA2 expression was significantly decreased in the group OA at two, four, and six weeks after injection (P<0.05 or 0.01). Compared to baseline, ATF-3 expression was significantly increased, and KCNA2 expression was significantly decreased in the group OA (P<0.05 or 0.01). Conclusion. Pain behavior in OA rats was associated with decreased KCNA2 expression in DRGs.

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Opioid use in knee or hip osteoarthritis: a region-wide population-based cohort study

Abstract: Opioid use in knee or hip osteoarthritis a region-wide population-based cohort study Thorlund, J. B.; Turkiewicz, A.; Prieto-Alhambra, D.; Englund, M.

Cited by 55 publications

References 32 publications

Comorbidities and their link with individual health status: A cross-sectional analysis of 23,892 people with knee and hip osteoarthritis from primary care

Comorbidities and their link with individual health status: A cross-sectional analysis of 23,892 people with knee and hip osteoarthritis from primary care

Understanding the Molecular Mechanisms Underlying the Pathogenesis of Arthritis Pain Using Animal Models

Relationship between Pain Behavior and Changes in KCNA2 Expression in the Dorsal Root Ganglia of Rats with Osteoarthritis

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