Osteoarthritis (OA) is the most prevalent joint disease in older people worldwide with knee and hips being the most affected joints. It is characterized by the progressive destruction of articular cartilage, synovial inflammation, changes in subchondral bone, and period- irregular muscle and pain. In particular, pain due to OA is contemplated as one of the commonest causes of chronic pain. Hands, knees, hips, lower back, and neck are the commonly affected body parts. It can happen at any age but it commonly starts in the 50s and affects women more than men. This disease starts slowly and gets worse as time goes by.
Symptoms of osteoarthritis
Symptoms tend to build over time rather than suddenly occurring. They include-
- Cracking sound when a joint bends
- Swelling around the joint
- Muscle weakness around the joint
Some of the health effects due to osteoarthritis include obesity, diabetes, heart disease, and high blood pressure. The management of osteoarthritis may require three lines of pharmacological treatment in order to-
1. Manage information only when it is present in its flares
2. Provide central analgesia by modulating both ascending and descending pathways
3. Prevent further joint destruction by using condroprotectores.
What is Tapentadol?
Tapentadol is a novel centrally-acting synthetic analgesic license in the UK for the management of severe chronic pain (Tapentadol prolonged release) and moderate to severe acute pain (Tapentadol immediate release) in adults which can be sufficiently managed only with opioid analgesics. Its analgesic efficacy is thought to be the result of mu-opioid receptor agonist activity and noradrenaline reuptake inhibition with both mechanisms residing in a single molecule.
Tapentadol in osteoarthritis treatment
Order Tapentadol prolonged release in severe chronic pain related to osteoarthritis
In a randomized, double-blind, placebo and active-controlled, parallel-arm, multi-center study, a total of 1030 patients with chronic osteoarthritis-related knee pain, patients received twice- daily doses of Tapentadol prolonged release 100-250 mg, oxycodone controlled release 20-50 mg or placebo for a total of 15 weeks. Both Tapentadol prolonged release and oxycodone controlled-release significantly reduced mean pain intensity scores throughout the treatment period with reported mean total daily doses of approximately 350 mg for Tapentadol prolonged release and 70 mg for oxycodone controlled-release remaining stable during the maintenance period. The most common treatment-emergent adverse events in the active treatment groups were nausea, vomiting, dizziness, fatigue, constipation. Incidences of constipation and the composite of nausea/ vomiting were significantly lower in the Tapentadol prolonged release group compared to the oxycodone control release group.
The improved overall and gastrointestinal tolerability of Tapentadol prolonged release is clinically important findings, as Tapentadol prolonged release provided more consistent pain relief with better tolerability than oxycodone controlled release, thus allowing patients to adhere to treatment for longer periods of time.
Tapentadol prolonged-release provides effective and well-tolerated treatment of severe chronic osteoarthritis pain for elderly patients in routine clinical practice. The marked improvements in all quality of life measures and the favorable tolerability profile, in particular, suggest Tapentadol prolonged release as an early treatment option before classical strong opioids are considered.
Tapentadol immediate or prolonged-release should be administered with caution to patients with respiratory depression. It should not be used in patients who may be susceptible to the effects of raised CSF pressure including patients with evidence of head injury and increased intracranial pressure.