PMID- 21477658
OWN - NLM
STAT- MEDLINE
DCOM- 20120105
LR  - 20220408
IS  - 1522-9653 (Electronic)
IS  - 1063-4584 (Linking)
VI  - 19
IP  - 8
DP  - 2011 Aug
TI  - Transdermal buprenorphine plus oral paracetamol vs an oral codeine-paracetamol 
      combination for osteoarthritis of hip and/or knee: a randomised trial.
PG  - 930-8
LID - 10.1016/j.joca.2011.03.011 [doi]
AB  - OBJECTIVE: Low-dose transdermal opioids offer a new therapeutic option for 
      osteoarthritis (OA). This study compared symptom relief obtained with 
      buprenorphine patches plus oral paracetamol with that obtained with an oral 
      codeine-paracetamol combination tablet (co-codamol) in older adults with OA. 
      METHOD: Two hundred and twenty people (aged >/=60 years) with OA hip and/or knee 
      pain were randomised to treatment with 7-day buprenorphine patches plus oral 
      paracetamol (5-25 mug/h buprenorphine patches plus 1000 mg oral paracetamol q.i.d. 
      (4 times daily); n=110) or co-codamol tablets (two 8/500-two 30/500 mg tablets 
      q.i.d.; n=110). They entered a titration period of up to 10 weeks, during which 
      their dose of study medication was adjusted until they reached optimum pain 
      control. Patients who achieved optimum pain control entered a 12-week assessment 
      period. The primary outcome was average daily pain scores recorded using the box 
      scale-11 (BS-11) pain scale. RESULTS: Both treatments significantly reduced 
      patient pain scores. The estimated treatment difference [95% confidence interval 
      (CI)] was -0.02 (-0.64, 0.60) for the per protocol (PP) population. The results 
      were similar for the full analysis population. Patients receiving 7-day 
      buprenorphine patches plus oral paracetamol needed significantly less escape 
      medication (ibuprofen) than those receiving co-codamol tablets (P=0.002; PP 
      population). Less than 10% of patients in the 7-day buprenorphine patches plus 
      oral paracetamol group were receiving the highest dose level at the end of the 
      study, compared with 34% in the co-codamol group. Withdrawal rates were high in 
      both groups. The incidence of adverse events (AEs) was comparable between the 
      groups (86.4% of patients in the 7-day buprenorphine patches plus oral 
      paracetamol group; 81.7% in the co-codamol group). Six serious AEs were reported 
      in three patients (2.7%) in the 7-day buprenorphine patches plus oral paracetamol 
      group and one (0.9%) in the co-codamol group. CONCLUSIONS: 7-day buprenorphine 
      patches plus oral paracetamol were non-inferior to co-codamol tablets with 
      respect to analgesic efficacy in older adults with OA pain in the hip/knee.
CI  - Copyright (c) 2011 Osteoarthritis Research Society International. Published by 
      Elsevier Ltd. All rights reserved.
FAU - Conaghan, P G
AU  - Conaghan PG
AD  - Section of Musculoskeletal Disease, University of Leeds & NIHR Leeds 
      Musculoskeletal Biomedical Research Unit, Leeds, UK. p.conaghan@leeds.ac.uk
FAU - O'Brien, C M
AU  - O'Brien CM
FAU - Wilson, M
AU  - Wilson M
FAU - Schofield, J P
AU  - Schofield JP
LA  - eng
SI  - ClinicalTrials.gov/NCT00324038
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20110406
PL  - England
TA  - Osteoarthritis Cartilage
JT  - Osteoarthritis and cartilage
JID - 9305697
RN  - 0 (Analgesics)
RN  - 0 (Analgesics, Non-Narcotic)
RN  - 0 (Analgesics, Opioid)
RN  - 0 (Drug Combinations)
RN  - 0 (acetaminophen, codeine drug combination)
RN  - 362O9ITL9D (Acetaminophen)
RN  - 40D3SCR4GZ (Buprenorphine)
RN  - UX6OWY2V7J (Codeine)
SB  - IM
CIN - Osteoarthritis Cartilage. 2012 Apr;20(4):336; author reply 337-8. PMID: 22285736
MH  - Acetaminophen/*administration & dosage
MH  - Administration, Cutaneous
MH  - Administration, Oral
MH  - Aged
MH  - Aged, 80 and over
MH  - Analgesics/*administration & dosage
MH  - Analgesics, Non-Narcotic/administration & dosage
MH  - Analgesics, Opioid/administration & dosage
MH  - Buprenorphine/*administration & dosage
MH  - Codeine/*administration & dosage
MH  - Drug Administration Schedule
MH  - Drug Combinations
MH  - Drug Therapy, Combination
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Osteoarthritis, Hip/*drug therapy
MH  - Osteoarthritis, Knee/*drug therapy
MH  - Pain Measurement
MH  - Treatment Outcome
EDAT- 2011/04/12 06:00
MHDA- 2012/01/06 06:00
CRDT- 2011/04/12 06:00
PHST- 2010/09/21 00:00 [received]
PHST- 2011/02/17 00:00 [revised]
PHST- 2011/03/28 00:00 [accepted]
PHST- 2011/04/12 06:00 [entrez]
PHST- 2011/04/12 06:00 [pubmed]
PHST- 2012/01/06 06:00 [medline]
AID - S1063-4584(11)00107-5 [pii]
AID - 10.1016/j.joca.2011.03.011 [doi]
PST - ppublish
SO  - Osteoarthritis Cartilage. 2011 Aug;19(8):930-8. doi: 10.1016/j.joca.2011.03.011. 
      Epub 2011 Apr 6.