Amidst a stringent regulatory environment, and with the rising use and abuse of narcotics and increasing regulation limiting narcotic analgesic use, the FDA approved (August 2015) the use of extended-release oxycodone in children (11 to 16 years old) with severe, "around-the-clock" pain

A network analysis of multiple therapies used in osteoarthritis found that acetaminophen (paracetamol) does not meet the minimum standard of clinical effectiveness in reducing pain or improving physical function in patients with knee and hip osteoarthritis.

The use of opioids has become increasingly problematic in the last few years. First, the rising rates of use and abuse, followed by greater restrictions and regulations that have curtailed use, and, finally, a resultant increase in illicit drug use (heroin) and opioid overdoses.

Vitamin D supplementation for individuals with knee osteoarthritis and low 25-hydroxyvitamin D levels did not reduce knee pain or slow cartilage loss, according to a study appearing in the March 8 issue of JAMA.

 

Highlights from this week on RheumNow:

Reuters reports that researchers at the University of Warwick have devised a new transdermal drug delivery patch that may change the future of pain management. 

Optimal sleep duration for adults is suppose to be 7 or more hours of sleep each night. Shorter sleep duration (7 hours per night) is associated with greater likelihoods of obesity, high blood pressure, diabetes, coronary heart disease, stroke, frequent mental distress, and death.

Wayne J Riley, MD, MPH, MBA, MACP, president of the American College of Physicians (ACP) sent a letter to the Centers for Disease Control and Prevention (CDC) reacting to its Draft Guideline for the Use of Opioids for Chronic Pain.

A new Cochrane Review published today shows that targeting exercises to muscles that support and control the spine offers another strategy to reduce pain and disability caused by lower back pain.

A recent Morbidity Mortality Weekly Report from the CDC reviewed the epidemic of drug overdose (poisoning) deaths in the USA.

Researchers at Stanford University analyzed 2013 Medicare Part D prescription drug coverage claims for narcotic painkillers containing hydrocodone, oxycodone, codeine and other opioids.  (Citation source http://buff.ly/1JgR2Tr)

I am often asked the question: When is the right time to taper a patient off opioids?

My view is that a patient should be tapered any time the risks exceed the benefits, or when treatment goals are not being met.

Researchers from Vanderbilt University have studied the issue of opioid use in rheumatoid arthritis (RA) and whether this influences infection risk.

A recent analysis of randomized clincal trials (RCT) for the treatment of neuropathic pain has shown in increase in placebo responses. (Citation source http://buff.ly/1LL8yAi)

A new JAMA study shows new onset back pain treated with physical therapy yields modest short-term (3 months) improvement. 

From 2003 to 2013, the percentage of nonmedical use of prescription opioids decreased among adults in the U.S., while the prevalence of prescription opioid use disorders, frequency of use, and related deaths increased, according to a study in the October 13 issue of JAMA.

Primary prevention of osteoarthritis is an ideal goal for which there has been little success in clinical trials.

PLOS has reported the results of the 2012 US National Health Interview Survey that focuses on fibromyalgia.

In August, RheumNow published 76 tweets covering novel news, research and teaching points gleaned from the medical literature, regulatory reports and internet sources. We had a reach (impressions) of 60,800, with 45 mentions, and 2049 visits to RheumNow.com.

The hallmarks of fibromyalgia -- widespread pain, poor sleep, effort intolerance, fatigue -- are difficult to manage and usually require medication and a multi-modal approach.