CHICAGO—Findings on opioid efficacy, serum urate in osteoarthritis and arthrocentesis headlined the top research of the year discussed in the first half of a session at the 2018 ACR/ARHP Annual Meeting. The second half covered basic science findings, including summaries of new insights into the gender bias in autoimmune diseases, platelet microparticles in scleroderma and fibroblasts in rheumatoid arthritis (RA).
Explore this issueDecember 2018
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Peter A. Merkel, MD, MPH, chief of rheumatology at the University of Pennsylvania in Philadelphia, reviewed clinical research over the past year following discussions with international experts. In the SPACE randomized clinical trial, 240 patients with back pain or hip or knee osteoarthritis pain were randomized to receive opioid or non-opioid medications in individually tailored regimens. The main findings: No difference was found in pain’s interference with function between the groups, and the non-opioid group had less pain intensity. Dr. Merkel said the trial “provides clinical guidance and support to a strategy of avoiding use of opioids for treatment of chronic musculoskeletal pain.”1
In a longitudinal cohort study, researchers found serum urate levels predict joint-space narrowing in patients without gout who have medial knee osteoarthritis (OA).2 The findings, Dr. Merkel said, suggest uric acid plays some role in OA but don’t show causality. They raise the question of whether urate-lowering treatment could prevent OA progression in some patients, and highlight the increasingly recognized complexity of OA pathogenesis.