Effective Non-Opioid Treatments for Osteoarthritis: Insights from ACR Convergence 2024

Arthritis is a major cause of daily activity limitations, disability, and chronic pain in the United States. Many patients with arthritis receive opioid prescriptions, contributing to the substance use disorder crisis. Osteoarthritis is the most common form, affecting 32.5 million US adults. It can disrupt sleep and mood, leading to significant economic costs.

Access to nonopioid treatments for osteoarthritis is essential. Research presented at ACR Convergence 2024 highlighted several potential therapies and their effects on patients.

Fasinumab

Fasinumab is a new monoclonal antibody aimed at reducing osteoarthritis symptoms. Some dosages may cause increased adverse effects, including joint issues. A meta-analysis of six trials with 9,429 patients found that certain doses of fasinumab significantly reduced pain and improved function compared to placebo. The preferred dosage for increased patient satisfaction scores is 1 mg every four weeks.

RTX-GRT7039

RTX-GRT7039 is a treatment that targets pain in knee osteoarthritis. In a phase 2 trial with 40 patients, those receiving RTX-GRT7039 showed reduced pain scores at three and six months compared to placebo. All treatment groups had notable improvements in pain and functionality.

Analgesic Antidepressants

Studies found that patients on analgesic antidepressants for osteoarthritis tended to experience worse pain than those on selective serotonin reuptake inhibitors (SSRIs). A study with 224 participants indicated that patients on analgesic antidepressants had higher pain severity and more pain sensitization over two years. Additionally, starting analgesic antidepressants was linked to a greater risk of knee or hip replacements compared to SSRIs.

Diclofenac Sodium 1% Gel

Diclofenac sodium 1% gel showed significant benefits in treating hand and knee osteoarthritis. In a combined analysis of two trials, patients using the gel reported better physical function and reduced pain levels. The gel significantly improved scores on both the WOMAC and AUSCAN indices, demonstrating its effectiveness in enhancing daily activities for patients with osteoarthritis.

These findings underscore the importance of diverse treatment options for osteoarthritis, aiming to improve patients’ quality of life while managing pain effectively.