How effective are oral or transdermal opioids in patients with osteoarthritis (OA) of the knee or hip?
The treatment durations were relatively short (3 days to 3 months; median 4 weeks). The reporting of safety outcomes was incomplete, with adverse events reported in 4 trials, and serious adverse events in 3 trials only. Most of the trials were funded by the pharmaceutical industry. While no evidence of long term effects is available from randomised trials, observational studies indicate long term treatment (>6 months) with opioids for chronic conditions, such as OA, may have deleterious effects, including poorer quality of life and reduced functional capacity, and does not seem to improve pain relief.² 2. Eriksen J et al. Pain 2006;125:172–79.
OA is the most common form of joint disease and the leading cause of pain and physical disability in the elderly. Opioids may be a viable treatment option if patients suffer from severe pain, or if other analgesics are contraindicated. However, the evidence on their effectiveness and safety is contradictory.