Opioid vs Non-Opioid Treatment for Pain-Related Function

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The researchers observed no significant difference between the groups in pain-related function over 12 months.
The researchers observed no significant difference between the groups in pain-related function over 12 months.

HealthDay News — Opioid treatment is not superior to non-opioid treatment for improving pain-related function over 12 months, according to a study published in the Journal of the American Medical Association.

Erin E. Krebs, MD, MPH, from the Minneapolis Veterans Affairs Health Care System, and colleagues compared opioid vs 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 randomly assigned to either opioid or non-opioid treatments; 234 completed the trial.

The researchers observed no significant difference between the groups in pain-related function over 12 months (overall P =.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% CI, −0.5 to 0.7).

Over 12 months, pain intensity was significantly better in the non-opioid group (overall P =.03); the mean BPI severity was 4.0 and 3.5 for the opioid and non-opioid groups, respectively (difference, 0.5; 95% CI, 0.0 to 1.0). Over 12 months, adverse medication-related symptoms were significantly more common in the opioid group (overall P =.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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Reference

Krebs EE, Gravely A, Nugent S, et al. Effect of opioid vs nonopioid medications on pain-related function in patients with chronic back pain or hip or knee osteoarthritis pain.  JAMA. 2018; 319(9): 872-882.

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