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Osteoarthritis
Managing Osteoarthritis-associated Pain

Congress updates

Read time: 70 mins
Last updated:4th Feb 2022
Published:30th Sep 2020

Start a conversation with your colleagues on clinical recommendations from 2021 and 2020 osteoarthritis (OA) congresses.

  • Watch short videos from EULAR 2021 of OA experts in a roundtable discussion
  • Catch up on key takeaways from ACR 2021 with Professor Tonia Vincent
  • Explore video updates from EULAR 2020, including best practice for intra-articular injection
  • Hear Professor Francis Berenbaum discuss recommendations from the 2019 ACR/AF guidelines

European League Against Rheumatism – EULAR 2021, expert roundtable

A roundtable discussion was formed comprising osteoarthritis (OA) experts to analyse important clinical OA updates from the European League Against Rheumatism (EULAR) 2021 Congress.

Meet the experts from the EULAR 2021 roundtable discussion, Professor Tonia Vincent, Professor Martin Englund and Dr Theresa Burkard.

The roundtable discussion focused on the assessment of OA-associated pain, 2021 guideline updates and knowledge gaps in OA-associated pain treatments.

Assessment of osteoarthritis-associated pain

Over 20% of chronic pain globally is associated with osteoarthritis (OA), with an increasing incidence associated with age and obesity. For many years, OA-associated pain was neglected, in part because of false beliefs on mechanisms and treatments. Currently, it is associated with important unmet needs, including suboptimal pain assessment.

In the videos below, the expert panel canvas key considerations in the best-practice assessment of OA-associated pain.

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ACR 2021 highlights

Follow an expert overview from Professor Tonia Vincent of ACR 2021 highlights, with commentary on emerging therapies, insights from epidemiology and genome-wide association studies, the role of growth factors and other targets, and the importance of multidisciplinary teams in osteoarthritis treatment today.

The most urgent unmet needs in the treatment of osteoarthritis
2

Meet the expert

Professor Tonia Vincent.pngProfessor Tonia Vincent
Director, Centre for Osteoarthritis Pathogenesis,
University of Oxford, UK Professor Vincent studied medicine at University College London, qualifying in 1993. She trained as a junior doctor in London, later specialising in Rheumatology.

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European League Against Rheumatism – EULAR 2020

The EULAR e-scientific sessions took place in Frankfurt, broadcasting both live and recorded presentations. Sessions of particular interest to osteoarthritis (OA) are presented below.

Tramadol’s mortality risk could outweigh its benefits

According to a large population-based study in Canada, patients with OA treated with tramadol presented a 20–50% higher risk of death during the first year of treatment, compared with patients receiving NSAIDs.

Within a year of starting treatment with tramadol, there was a 20% increase in all-cause mortality when compared with naproxen (death rate of 21.5 vs 17.8 per 1,000 person-years, respectively; hazard ratio [HR] of 1.2). Similar results were observed when comparing tramadol with diclofenac (HR, 1.3) and cyclooxygenase (COX)-2 inhibitors (HR, 1.5). However, all-cause mortality was lower with tramadol than codeine (21.5 vs 25.5 per 1,000 person-years; HR, 0.8).

These findings add further weight to the excess mortality risk of tramadol highlighted last year by Zeng et al. in JAMA3 [link: dx.doi.org/10.1001/jama.2019.1347]

More information about the study

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Join Professor Francis Berenbaum to find out the key changes and recommendations from the 2020 ACR/AF guidelines 

The recent update of the 2019 American College of Rheumatology (ACR)/Arthritis Foundation (AF) guidelines for the comprehensive management of osteoarthritis (OA) of the Hand, Hip, and Knee contained a number of notable changes and recommendations7.

Below you can discover the key changes to the guidelines as well as important considerations in OA physical therapy. Also stay up to date on studies comparing physical therapy and glucocorticoids, the impact of non-steroidal anti-inflammatory drugs (NSAIDs) on coronavirus disease 2019 (COVID-19) susceptibility, anti-nerve growth factor (anti-NGF) efficacy and safety, and research into anti-interleukin-6 (anti-IL6) treatments.

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  1. Perrot S. Osteoarthritis Pain: Pathophysiology, Diagnosis, and Management. 2016. https://s3.amazonaws.com/rdcms-iasp/files/production/public/Content/ContentFolders/GlobalYearAgainstPain2/2016/FactSheets/English/13. Osteoarthritis Pain.pdf. Accessed 21 September 2021.
  2. Unruh AM. Pain in women. Pain Research and Management. 2008;13(3):199–200.
  3. Zeng C, Dubreuil M, Larochelle MR, Lu N, Wei J, Choi HK, et al. Association of tramadol with all-cause mortality among patients with osteoarthritis. JAMA. 2019;321(10):969–982.
  4. Pelle T, Bevers K, Van Der Palen J, Van Den Hoogen FHJ, Van Den Ende CHM. Development and evaluation of a tailored e-self-management intervention (dr. Bart app) for knee and/or hip osteoarthritis: Study protocol. BMC Musculoskelet Disord. 2019;20(1):1–12.
  5. Pelle T, Bevers K, van der Palen J, van den Hoogen FHJ, van den Ende CHM. Effect of the dr. Bart application on healthcare use and clinical outcomes in people with osteoarthritis of the knee and/or hip in the Netherlands; a randomized controlled trial. Osteoarthr Cartil. 2020;28(4):418–427.
  6. Kedor C, Detert J, Rau R, Wassenberg S, Listing J, Klaus P, et al. Hydroxychlotoquine in patients with inflammatory and erosive osteoarthritis of the hands: Results of a randomized, double-blind, placebo controlled, multi-centre, investigator-initiated trial (OA TREAT). Ann Rheum Dis. 2020;79(Suppl 1):115 [0P0186].
  7. Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block J, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Rheumatol. 2020;72(2):220–233.
  8. Deyle GD, Allen CS, Allison SC, Gill NW, Hando BR, Petersen EJ, et al. Physical Therapy versus Glucocorticoid Injection for Osteoarthritis of the Knee. N Engl J Med. 2020;382(15):1420–1429.
  9. Chandan JS, Zemedikun DT, Thayakaran R, Byne N, Dhalla S, Acosta‐Mena D, et al. Non‐steroidal anti‐inflammatory drugs and susceptibility to COVID‐19. Arthritis Rheumatol. 2020;art.41593.
  10. Schnitzer T, Berenbaum F, Conaghan PG, Dworkin R, Yamabe T, Davignon I, et al. Clinically Important Improvement in Osteoarthritis Pain at Week 16 after Subcutaneous Administration of Tanezumab: Pooled Analysis from International Studies. In: Arthritis and Rheumatology. 2020: 3310–3311.
  11. Hunter D, Neogi T, Churchill M, Shirinsky I, Omata M, White A, et al. Clinically Important Improvements in Patients with Osteoarthritis Treated with Subcutaneous Tanezumab: results from a 56-Week Randomized NSAID-Controlled Study. Arthritis and rheumatology. 2020;72(SUPPL 10):3311‐3313.
  12. Neogi T, Hunter D, Churchill M, Shirinsky I, Omata M, White A, et al. Observed Efficacy with Subcutaneous Tanezumab Is Early and Maintained in Patients with Osteoarthritis: results from a 56-Week Randomized NSAID-Controlled Study. Arthritis and rheumatology. 2020;72(SUPPL 10):3314‐3316.
  13. NCT02477059, Effect of the Interleukin-6 Receptor Antagonist Tocilizumab in Patients With Hand Osteoarthritis. ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT02477059. Accessed 8 January 2021.

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