hydrocodone and Osteoarthritis

The objective of this study was to evaluate continued pain control and tolerability of converting patients from Vicodin (hydrocodone/acetaminophen; HCD/APAP) to the buprenorphine transdermal system (BTDS).. Adult patients with pain from osteoarthritis receiving a stable dosage of HCD/APAP (i.e., 15 - 30 mg hydrocodone/day) were switched to an equivalent or near-equivalent dosage of open-label Vicodin for 7 days. Patients maintaining acceptable analgesia were stratified based on their Vicodin dosage and randomized to receive either titratable BTDS 10 μg/h or fixed-dose BTDS 20 μg/h. The primary efficacy variable was completion of the 14-day double-blind phase. Tolerability was assessed.. A total of 84.3% of patients met the primary end point, completion of the 14-day double-blind phase (167/198 patients, 95% CI 79.3 - 89.4). Adverse events were consistent with those associated with the use of opioid analgesics and transdermal patches.. There was a similar analgesic and tolerability profile when patients treated with Vicodin for osteoarthritis pain were switched to 7-day BTDS treatment.

Topics: Acetaminophen; Administration, Cutaneous; Administration, Oral; Aged; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Arthralgia; Buprenorphine; Double-Blind Method; Drug Combinations; Drug Substitution; Female; Humans; Hydrocodone; Kaplan-Meier Estimate; Male; Middle Aged; Osteoarthritis; Pain Measurement; Time Factors; Transdermal Patch; Treatment Outcome; United States

The purpose of this study was to evaluate current surgical practice patterns, the factors that influence these patterns, and overall trends in the treatment of thumb carpometacarpal osteoarthritis.. An online survey containing 14 questions was sent to all active members of the American Society for Surgery of the Hand. Information on demographics and treatments was collected. Results were anonymously uploaded to an online spreadsheet.. A total of 823 responses were recorded. Trapeziectomy with ligament reconstruction and tendon interposition (LRTI) using whole flexor carpi radialis was the most popular technique at 37.44%. In all, 26.38% of surgeons with fewer than 5 years of experience utilize trapeziectomy with suture suspension (bone anchor based or tendon based); 55.76% choose a particular procedure because of "Personal Clinical Experience" over "Current Evidence" and "Training." In addition, 24.17% of surgeons who have been practicing for longer than 5 years have changed procedures in the last 5 years. In the United States, 97.2% of hand surgeons prescribe either oxycodone or hydrocodone postoperatively compared with just 23.75% of international hand surgeons.. The results show that trapeziectomy with LRTI remains the most popular treatment of choice. The use of trapeziectomy with suture suspension is on the rise, particularly in younger surgeons. International hand surgeons rely more on current evidence, utilize less postoperative therapy and opioid medications, and change procedures more often than US hand surgeons.

Topics: Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Carpometacarpal Joints; Clinical Competence; Drug Prescriptions; Humans; Hydrocodone; Immobilization; Orthopedic Procedures; Osteoarthritis; Oxycodone; Pain, Postoperative; Postoperative Care; Practice Patterns, Physicians'; Surgeons; Surveys and Questionnaires; Thumb; United States

Osteoarthritis (OA)-related chronic pain is associated with physical and psychosocial impairment as well as poorer quality of life. There is limited literature on long-term opioid therapy in OA patients. This post hoc analysis of OA patients assessed the long-term safety and effectiveness of a once-daily, single-entity, extended-release formulation of hydrocodone (HYD) with abuse-deterrent properties for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which other treatment options are inadequate.. This is a post hoc analysis of the 307 patients with OA pain from a primary open-label study. Following screening and dose titration, patients who achieved a stable HYD dose continued into a 52-week maintenance period. Supplemental non-opioid or short-acting opioid analgesics were allowed throughout the study. Safety was monitored. Effectiveness evaluations included "average pain over the last 24 hours" scores, "pain right now" scores, Brief Pain Inventory-Short Form and treatment satisfaction questionnaire.. No new or unexpected safety concerns emerged during treatment with HYD. HYD demonstrated a safety profile consistent with other µ-opioid agonists with 22% discontinuations of treatment due to adverse events, a majority of which were related to the study drug. Clinically meaningful analgesia was achieved as mean "average pain over the last 24 hours"; scores decreased by 2.9 points from baseline to the end of maintenance. During the maintenance period, pain severity declined 2.7 points and interference by 2.5 points from baseline. Mean "pain right now" scores were similar at dosing and 12 hours later. A majority of patients reported satisfaction with HYD.. In OA patients, long-term HYD treatment was generally well tolerated and provided clinically important analgesia.

Topics: Adult; Aged; Aged, 80 and over; Analgesics, Opioid; Chemistry, Pharmaceutical; Chronic Pain; Delayed-Action Preparations; Female; Humans; Hydrocodone; Male; Middle Aged; Osteoarthritis; Prescription Drug Misuse; United States; Young Adult