A large-scale meta-analysis recently published in The Lancet concludes that taken alone, acetaminophen is “not eff
ective at any dose” for relieving pain or improving physical function for patients with osteoarthritis.
Dr. Sven Trelle, of the University of Bern in Switzerland, and colleagues found found that acetaminophen – also known as paracetamol – was only marginally better than a placebo for treating symptoms of the degenerative joint disease.
The team found that the non-steroidal anti-inflammatory drug (NSAID) diclofenac was most effective for short-term pain relief from osteoarthritis, though the authors recommend against taking the medication long term due to its side effects.
Acetaminophen and NSAIDS are considered a first-line treatment for relieving mild-to-moderate pain among patients with osteoarthritis, though Dr. Trelle and colleagues note that acetaminophen is widely used in the long term because it poses fewer side effects than NSAIDS.
Overall the studies compared the effects of 22 different medications – including acetaminophen and 7 different classes of NSAIDS – against a placebo, assessing how they affected patients’ pain intensity and physical function at various doses.
All medications at all doses appeared to have beneficial effects in comparison with a placebo.
However, while some doses of paracetamol offered a slight improvement in pain intensity and physical function for patients, the effect did not reach the minimum standards of clinical effectiveness – defined as the smallest change in a treatment outcome that a patient would deem important.
Commenting on the results, Dr. Trelle says: “NSAIDS are usually only used to treat short-term episodes of pain in osteoarthritis, because the side effects are thought to outweigh the benefits when used longer term. Because of this, paracetamol is often prescribed to manage long-term pain instead of NSAIDS. However, our results suggest that paracetamol at any dose is not effective in managing pain in osteoarthrits, but that certain NSAIDS are effective and can be used intermittently without paracetamol.”
He adds that he hopes the findings will “better inform doctors about how to manage pain” in patients with osteoarthritis.
March 18, 2016
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