A team of researchers from the United States and Sweden have conducted a systematic review and meta-analyses of randomised controlled trials (RCTs) to evaluate whether an association exists between an opioid’s μ receptor binding affinity and its efficacy/safety, specifically in patients with knee and/or hip osteoarthritis. A total of 18 RCTs, involving 9,283 participants, were included in the study. At 2, 4, 8 and 12 weeks, both pain and function were slightly improved following opioid usage (standardised mean differences [95% CI] ranged from -0.18 [‐0.38, ‐0.17] to ‐0.19 [‐0.29, ‐0.08]. Researchers reported consistently lower efficacy and higher safety risks associated with strong opioids compared to weak/intermediate opioids. Due to the increased safety risks, incremental analgesia achieved at higher doses were not considered to be significant. The reduced efficacy and increased risk of side effects associated with opioids in this cohort suggests alternatives should be considered for the management of osteoarthritis. The original article can be viewed here.

Contributed by Australian Medication Safety Services Associate, Isabella Singh