Chronic Oxycodone Therapy Beneficial for Osteoarthritis-Related Pain

WESTPORT, Apr 07 (Reuters Health) - Controlled-release oxycodone therapy is safe and effective for managing pain associated with chronic, moderate to severe osteoarthritis, according to a report in the March 27th issue of the Archives of Internal Medicine.

Dr. Sanford H. Roth, of ArthroCare in Phoenix, Arizona, and associates evaluated the effects of 10 or 20 mg of controlled-release (CR) oxycodone twice daily, compared with placebo, in 133 patients with persistent osteoarthritis-related pain.

Use of 20 mg of CR oxycodone twice daily resulted in a 20% average reduction in baseline pain intensity within 1 day, and use of 10 mg twice daily achieved the same result by day 2, the authors report. The placebo group never achieved a 20% average pain reduction.

More than half the patients discontinued study participation prematurely, but for different reasons. Significantly more placebo patients discontinued for ineffective treatment, the investigators note, while treated patients were more likely to discontinue for adverse events, principally gastrointestinal.

Subjective assessments of pain using the Brief Pain Inventory "showed that use of 20 mg of CR oxycodone q12h was significantly more effective than placebo use in improvement from baseline for pain right now and for worst and average pain in the last 24 hours," the researchers write.

The 20-mg CR oxycodone group also showed significant improvements in mood, sleep and enjoyment of life, the results indicated. Similar improvements in the 10-mg CR oxycodone group did not reach statistical significance.

In a long-term extension of the study, pain control below a "moderate" level was maintained at daily doses of CR oxycodone ranging from 39 to 41 mg, the investigators report.

Among 106 participants in the long-term portion of the study, only one person, a patient who abruptly discontinued CR oxycodone 70 mg/day, experienced withdrawal symptoms, the researchers observe, but no withdrawal symptoms were encountered by patients during scheduled respites from drug therapy.

"Opioid analgesic therapy might offer an alternative for patients whose pain cannot be controlled by use of weaker analgesics or in whom use of nonsteroidal anti-inflammatory drugs is contraindicated," the authors conclude.

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