Efficacy of oxycodone/acetaminophen and codeine/acetaminophen vs. conventional therapy in elderly women with persistent, moderate to severe osteoarthritis-related pain.
We aimed to evaluate the efficacy and safety of oxycodone/acetaminophen (O/A) and codeine/acetaminophen (C/A) vs. conventional therapy (CT) without opioids in older women suffering from osteoarthritis (OA)-related pain, sub-optimally responsive to prior conventional treatments. We performed a 6 week, randomized, single blind, controlled study in three nursing homes. We enrolled 154 women with painful OA. They were assigned to treatment with O/A (n=52) and C/A (n=52) vs. CT (n=50). We evaluated at baseline and at week 6: average pain in the last week (mean pain, MeP), pain at rest (RP), pain in movement (MP) (numeric rating scale, NRS); depressive symptoms (Beck Depression Inventory-II, BDI-II); functional status (activities of daily living, ADL) and cognitive status (mini mental state evaluation, MMSE). We considered the adverse events (AEs) in the study period. At week 6, MeP, RP and MP were significantly reduced in all three groups (p<0.001); compared to CT, O/A and C/A were associated with greater reductions in MeP (p<0.001 and p=0.004, respectively), in RP (p=0.028 and p=0.032, respectively) in MP (p<0.001 and p=0.002, respectively) and with significant improvement in BDI-II score (p=0.05 and p=0.04, respectively) and ADL value (p=0.04 and p=0.05, respectively). AE rates did not differ between groups.
Corsinovi
Laura
L
Section of Geriatrics, Department of Medical and Surgical Disciplines, University of Turin, Ospedale San Giovanni Battista-Molinette, Corso Bramante 88, I-10126 Torino, Italy. laura.corsinovi@libero.it
Martinelli
Elisa
E
Fonte
Gianfranco
G
Astengo
Marco
M
Sona
Alessandro
A
Gatti
Antonia
A
Massaia
Massimiliano
M
Bo
Mario
M
Zanocchi
Mauro
M
Michelis
Giuliana
G
Isaia
Gianluca
G
Molaschi
Mario
M
D000082:Acetaminophen / Q000627:therapeutic use*; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D003061:Codeine / Q000627:therapeutic use*; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D010003:Osteoarthritis / Q000188:drug therapy*; D010098:Oxycodone / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy*; D016037:Single-Blind Method
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D004338:Drug Combinations; C526278:acetaminophen, codeine drug combination; C514822:oxycodone-acetaminophen; D000082:Acetaminophen; D010098:Oxycodone; D003061:Codeine