There is a lack of evidence that medicines for osteoarthritis are effective in the long term, according to a review in the Journal of the American Medical Association (25 December 2018)
The network meta-analysis used data from 47 randomised controlled trials lasting at least 12 months, including 22,037 people with knee osteoarthritis, which explored the effects of 31 medicines on pain, 13 medicines on physical function and 16 medicines on joint structure.
The team found that only celecoxib and prescription glucosamine sulphate were associated with significant decreases in pain compared with placebo. In subanalyses, including those that excluded studies at high risk of bias, these results only remained significant for prescription glucosamine sulphate.
Glucosamine sulphate was also associated with improvement in physical function and joint structure while celecoxib was not.
While there is good evidence for the efficacy of pharmacological agents in short-term pain relief, much research in osteoarthritis has not considered long-term outcomes, the researchers explained.
“Larger randomised clinical trials are needed to resolve the uncertainty around the long-term efficacy of medications for knee osteoarthritis,” they concluded.
 Gregori D, Giacovelli G, Minto C et al. Association of pharmacological treatments with long-term pain control in patients with knee osteoarthritis: a systematic review and meta-analysis. JAMA 2018;320(24):2564–2579. doi: 10.1001/jama.2018.19319