Opioids Don't Top Non-Opioids for Pain-Related Function
TUESDAY, March 6, 2018 -- Opioid treatment is not superior to non-opioid treatment for improving pain-related function over 12 months, according to a study published in the March 6 issue of the Journal of the American Medical Association.
Erin E. Krebs, M.D., M.P.H., from the Minneapolis Veterans Affairs Health Care System, and colleagues compared opioid versus non-opioid medications over 12 months in a randomized trial. Two hundred forty patients with moderate-to-severe chronic back pain or hip or knee osteoarthritis pain despite analgesic use were randomized; 234 completed the trial.
The researchers observed no significant difference between the groups in pain-related function over 12 months (overall P = 0.58); the mean 12-month Brief Pain Inventory (BPI) interference was 3.4 and 3.3 for the opioid and non-opioid groups, respectively (difference, 0.1; 95 percent confidence interval, −0.5 to 0.7). Over 12 months, pain intensity was significantly better in the non-opioid group (overall P = 0.03); the mean BPI severity was 4.0 and 3.5 for the opioid and non-opioid groups, respectively (difference, 0.5; 95 percent confidence interval, 0.0 to 1.0). Over 12 months, adverse medication-related symptoms were significantly more common in the opioid group (overall P = 0.03).
"Results do not support initiation of opioid therapy for moderate-to-severe chronic back pain or hip or knee osteoarthritis pain," the authors write.
One author disclosed financial ties to the pharmaceutical industry.
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Posted: March 2018