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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. …
Competing interests None.