Pain treatment in arthritis-related pain: Beyond NSAIDs

Mart van de Laar, Joseph V. Pergolizzi, Hans Ulrich Mellinghoff, Ignacio Morón Merchante, Srinivas Nalamachu, Joanne O'Brien, Serge Perrot, Robert B. Raffa

Research output: Contribution to journalArticle

Abstract

Managing pain from chronic conditions, such as, but not limited to, osteoarthritis and rheumatoid arthritis, requires the clinician to balance the need for effective analgesia against safety risks associated with analgesic agents. Osteoarthritis and rheumatoid arthritis pain is incompletely understood but involves both nociceptive and non-nociceptive mechanisms, including neuropathic mechanisms. Prevailing guidelines for arthritis-related pain do not differentiate between nociceptive and non-nociceptive pain, sometimes leading to recommendations that do not fully address the nature of pain. NSAIDs are effective in treating the nociceptive arthritis-related pain. However, safety concerns of NSAIDs may cause clinicians to undertreat arthritis-related pain. In this context, combination therapy may be more appropriate to manage the different pain mechanisms involved. A panel convened in November 2010 found that among the currently recommended analgesic products for arthritis-related pain, fixed-low-dose combination products hold promise for pain control because such products allow lower doses of individual agents resulting in decreased toxicity and acceptable efficacy due to synergy between the individual drugs. Better evidence and recommendations are required to improve treatment of chronic arthritis-related pain.

Original languageEnglish (US)
Pages (from-to)320-330
Number of pages11
JournalOpen Rheumatology Journal
Volume6
Issue number1
DOIs
StatePublished - 2012

Fingerprint

Non-Steroidal Anti-Inflammatory Agents
Arthritis
Pain
Therapeutics
Osteoarthritis
Analgesics
Rheumatoid Arthritis
Safety
Chronic Pain
Analgesia
Guidelines

Keywords

  • Analgesia
  • Fixed-dose combination products
  • NSAID
  • Osteoarthritis
  • Paracetamol
  • Rheumatoid arthritis
  • Tramadol

ASJC Scopus subject areas

  • Rheumatology

Cite this

van de Laar, M., Pergolizzi, J. V., Mellinghoff, H. U., Merchante, I. M., Nalamachu, S., O'Brien, J., ... Raffa, R. B. (2012). Pain treatment in arthritis-related pain: Beyond NSAIDs. Open Rheumatology Journal, 6(1), 320-330. https://doi.org/10.2174/1874312901206010320

Pain treatment in arthritis-related pain : Beyond NSAIDs. / van de Laar, Mart; Pergolizzi, Joseph V.; Mellinghoff, Hans Ulrich; Merchante, Ignacio Morón; Nalamachu, Srinivas; O'Brien, Joanne; Perrot, Serge; Raffa, Robert B.

In: Open Rheumatology Journal, Vol. 6, No. 1, 2012, p. 320-330.

Research output: Contribution to journalArticle

van de Laar, M, Pergolizzi, JV, Mellinghoff, HU, Merchante, IM, Nalamachu, S, O'Brien, J, Perrot, S & Raffa, RB 2012, 'Pain treatment in arthritis-related pain: Beyond NSAIDs', Open Rheumatology Journal, vol. 6, no. 1, pp. 320-330. https://doi.org/10.2174/1874312901206010320
van de Laar M, Pergolizzi JV, Mellinghoff HU, Merchante IM, Nalamachu S, O'Brien J et al. Pain treatment in arthritis-related pain: Beyond NSAIDs. Open Rheumatology Journal. 2012;6(1):320-330. https://doi.org/10.2174/1874312901206010320
van de Laar, Mart ; Pergolizzi, Joseph V. ; Mellinghoff, Hans Ulrich ; Merchante, Ignacio Morón ; Nalamachu, Srinivas ; O'Brien, Joanne ; Perrot, Serge ; Raffa, Robert B. / Pain treatment in arthritis-related pain : Beyond NSAIDs. In: Open Rheumatology Journal. 2012 ; Vol. 6, No. 1. pp. 320-330.
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