Opioid vs Non-Opioid Treatment for Pain-Related Function

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.

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.