ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2132

Short-Run Transitions In Pain States: Reflections Of Multiple Outcome Clinical Measures of Inadequate Pain Relief among Patients With Knee Osteoarthiritis

Stephanie Taylor1, Christopher Black2, Paul M. Peloso3, Philip G. Conaghan4, Leah Stokes2, Mart A.F.J. van de Laar5, François Rannou6, Nigel K. Arden7 and Panagiotis Mavros2, 1Global Health Outcomes, Merck & Co., Inc., Whitehouse Station, NJ, 2Global Health Outcomes, Merck, Whitehouse Station, NJ, 3Clinical Research, Merck Sharp & Dohme Corp., Rahway, NJ, 4Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom, 5Rheumatology, University of Twente & Medisch Spectrum Twente, Enschede, Netherlands, 6Physical Medicine and Rehabilitation Service, Paris-Descartes University, Cochin Hospital, Paris, France, 7NDORMS; MRC Lifecourse Epidemiology Unit, Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, United Kingdom

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: , ,

Session Information

Title: Osteoarthritis - Clinical Aspects II: Symptoms and Therapeutics in Osteoarthritis.

Session Type: Abstract Submissions (ACR)

Background/Purpose: Despite the importance of pain management in osteoarthritis (OA), there has been limited evidence confirming the adequacy of measuring pain relief in clinical practice setting. The objective of the Survey of Real World Therapies in Osteoarthritis (SORT) is to evaluate short run (30 days) changes in pain relief and its association with overall pain, physical functioning, stiffness and quality of life in patients with knee OA.

Methods: SORT, a 12-month prospective multinational study enrolled participants with knee OA receiving analgesics.  Inadequate Pain Relief (IPR) was defined as a score of >4, indicating “moderate or greater pain”, on BPI Question “What is your pain on average?”.  The Short-Form (SF)-12 and WOMAC were administered to measure quality of life, pain, stiffness, and physical function. Baseline and month one data were used to assess short run dynamics of knee OA management.

Results: 1254participants were included: 67.3% women; mean age 68 years (SD=9.4); mean OA duration 5.9 years (SD=6.2). IPR was reported by 54% of the cohort. Overall, NSAIDs (64.1%) were used most often; followed by paracetamol (39.8%) and medications containing opioids (20.2%) . IPR participants (vs. non-IPR) used more opioid containing medications (24.7% vs. 14.8%, p< 0.001). IPR participants (vs. non-IPR) differed QOL on: WOMAC Stiffness (115 vs. 67, p< 0.001), Pain (266 vs. 136, p< 0.001), Physical Function (892 vs. 459, p<0.001); SF-12 General Health (fair/poor 47% vs. 27%, p<0.001); Additionally, there were  differences in IPR participants' report of response to treatment (fair, poor and no response 67% vs. 43%, p<0.001) as compared to non-IPR.

After 30 days, 28% of participants reported changes in pain relief, which was equally distributed (14% each) between the two baseline pain relief states. Participants whose pain relief state worsened experienced an average increase in pain measured by the BPI (27%) and WOMAC (9%). These participants also displayed worsened physical functioning (8%), greater knee stiffness (4%), as well as a decrease in health-related quality of life as measured by the physical component summary score (PCS) (2.1%) and mental component score (MCS) (2.7%).

In contrast, for those participants whose pain relief state improved, the BPI and WOMAC pain measurements improved 28% and 12%, respectively. Similarly, improvements were seen in physical functioning (8%), stiffness (11%) and both SF-12 components (1.8% each).

Conclusion:  Short run changes in pain relief status were positively associated with significant changes in both the physical (PCS) and mental (MCS) components of SF-12, and the 3 domains of the WOMAC.

Disclosure:

S. Taylor,

Merck ,

3;

C. Black,

Merck Pharmaceuticals,

3;

P. M. Peloso,

Merck Pharmaceuticals,

3;

P. G. Conaghan,
None;

L. Stokes,

Merck Pharmaceuticals,

3;

M. A. F. J. van de Laar,
None;

F. Rannou,
None;

N. K. Arden,
None;

P. Mavros,

Merck Pharmaceuticals,

3.

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