Last updated on Jan 22nd, 2021 at 01:06 pm

In a large-scale analysis of pain-relief medication for osteoarthritis, researchers found that paracetamol does not meet the minimum standard of clinical effectiveness in reducing pain or improving physical function in patients with knee and hip osteoarthritis.

Although paracetamol was slightly better than a placebo, researchers conclude that, taken on its own, paracetamol has no role in the treatment of patients with osteoarthritis, irrespective of dose.

The study, published in The Lancet, is the largest analysis of randomised trials of medical pain relief for osteoarthritis to date, and finds that diclofenac, a non-steroidal anti-inflammatory drug (NSAID), is the most effective short-term pain relief. However, the authors caution against long-term use of NSAIDs (e.g. ibuprofen, nurofen, etc.) because of known side-effects.

Osteoarthritis is the leading cause of pain in elderly people. It can impair physical activity, which increases patients’ risk of obesity, cardiovascular disease, diabetes and general ill-health.

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Dr Sven Trelle from the University of Bern, Bern, Switzerland and colleagues, pooled data from 74 randomised trials published between 1980 and 2015. The study involved a total of 58 556 patients with osteoarthritis.

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Paracetamol and NSAIDs are usually the first line of treatment for mild to moderate pain management in osteoarthritis, but paracetamol is used more frequently in the long term because of the cardiovascular and gastrointestinal side effects associated with long-term NSAID use.

According to Dr Trelle, “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. 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.”

For full Article and linked Comment see: http://press.thelancet.com/NSAIDsOA.pdf

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