People who are newly diagnosed with knee or hip osteoarthritis continue to take non-steroidal anti-inflammatory drugs (NSAIDs) despite contraindications, a new study shows.
A team from Boston University Chobanian & Avedisian School of Medicine found that these individuals had higher use of opioids and weren’t engaging in physical therapy during the first year after being diagnosed — two other factors that don’t align with current treatment guidelines for osteoarthritis.
The report was published July 26 in Osteoarthritis and Cartilage.
The team evaluated data on people living in Sweden who didn’t have an osteoarthritis diagnosis in their knees or hips from 2004 to 2013. They identified those with knee or hip osteoarthritis between 2014 and 2018 who had contraindications to, or precautions for, oral NSAIDs at the time they were diagnosed. Then the investigators estimated the risk of regular oral NSAID use, regular opioid use and utilization of physical therapy during the first year of diagnosis. The team compared that data to those without contraindications or precautions.
Among those with contraindications to NSAIDs, 21% used the drugs regularly during the first year after their diagnosis. The study also found a higher proportion of participants with contraindications used opioids regularly compared to those without contraindication. Additionally, a lower proportion of people overall used physical therapy.
The lower use of physical therapy is particularly concerning, the researchers, noted, given that many professional societies recommend physical therapy and exercise as first-line therapies for knee and hip osteoarthritis. The services are also covered with a copay in the country.”We found individuals with contraindications to NSAIDs were still commonly prescribed them, placing them at risk for NSAID-related adverse events,” Tuhina Neogi, MD, a professor and author at Boston University, said in a statement. “Additionally, they were not more likely to receive safer alternatives like physical therapy despite its widespread recommendation as first-line intervention.”
