Opioids and Other Treatments to Manage Osteoarthritis

National Harbor, Maryland—Although there is no known cure for osteoarthritis (OA), there are several pharmacologic and nonpharmacologic treatments used to manage the disease and its symptoms. At the AAPM meeting, researchers discussed the various alternatives during a satellite symposium titled Osteoarthritis: From Biomarkers to New Strategies for Pain Management. Affecting nearly 27 million adults, OA is the most common form of arthritis and the leading source of physical disability in the United States. It is associated with pain and loss of joint function. The disease is identified when physicians see structural abnormalities on plain radiographs and magnetic resonance images. Patients with OA may suffer from pain, stiffness, fatigue, and sleep disturbance that can limit physical function, cause physical disability, and reduce health-related quality of life. Virginia Byers Kraus, MD, PhD, professor of medicine in the division of rheumatology at Duke University’s Medical Center, Durham, North Carolina, began the session by outlining OA’s stages: molecular, preradiographic, radiographic, and joint replacement. Dr. Kraus said pain can occur in any of the stages but that there is a need to better understand the stages and when and how to intervene with the pain. According to Dr. Kraus, biomarkers may be able to help ease pain in OA patients. She suggested biomarkers may identify preradiographic OA or pain sensitivity and differentiate joint pain with or without structural degeneration. There are also biomarkers of drug metabolism that could predict efficacy and biomarkers that could forecast short- and long-term pain outcomes. 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