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Aetiology
Case control
Use of narcotic analgesics associated with increased falls and fractures in elderly patients with osteoarthritis
  1. Rajender R Aparasu,
  2. Satabdi Chatterjee
  1. Department of Clinical Sciences and Administration, College of Pharmacy, University of Houston, Houston, Texas, USA
  1. Correspondence to: Dr Rajender R Aparasu, Department of Clinical Sciences and Administration, College of Pharmacy, University of Houston, 1441 Moursund Street, Texas Medical Center, Houston, TX 77030, USA; rraparasu{at}uh.edu

https://doi.org/10.1136/eb-2013-101401

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    Commentary on: Rolita L, Spegman A, Tang X, et al. Greater number of narcotic analgesic prescriptions for osteoarthritis is associated with falls and fractures in elderly adults. J Am Geriatr Soc 2013;61:335–40OpenUrlCrossRefPubMed

    Context

    Pain control is a critical component in osteoarthritis (OA) management in the elderly. Opioid and non-opioid analgesics are commonly used to manage pain in OA patients.1 New non-steroidal anti-inflammatory drugs (NSAIDs) such as cyclooxygenase 2 (COX2) inhibitors emerged as non-opioid alternatives to pain management in early 2000 due to selective COX2 effects. However, some COX2 drugs were removed from the market in 2005 owing to elevated cardiovascular risks. This led the OA treatment guidelines to recommend the use of non-selective NSAIDs and opioid analgesics. However, recent studies suggest that patients using narcotic analgesics are at a higher risk of cardiovascular adverse events and falls/fractures compared with those using selective and non-selective NSAIDs. …

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    Footnotes

    • Competing interests None.