Treating osteoarthritis pain: mechanisms of action of acetaminophen, nonsteroidal anti-inflammatory drugs, opioids, and nerve growth factor antibodies

Yvonne D’Arcy, Patrick Mantyh, Tony Yaksh, Sean Donevan, Jerry Hall, Mojgan Sadrarhami, Lars Viktrup

Research output: Contribution to journalReview articlepeer-review

Abstract

Osteoarthritis (OA) is a common difficult-to-treat condition where the goal, in the absence of disease-modifying treatments, is to alleviate symptoms such as pain and loss of function. Acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and opioids are common pharmacologic treatments for OA. Antibodies directed against nerve growth factor (NGF-Abs) are a new class of agents under clinical investigation for the treatment of OA. This narrative review describes (and uses schematics to visualize) nociceptive signaling, chronification of pain, and the mechanisms of action (MOAs) of these different analgesics in the context of OA-related pain pathophysiology. Further, the varying levels of efficacy and safety of these agents observed in patients with OA is examined, based on an overview of published clinical data and/or treatment guidelines (when available), in the context of differences in their MOAs.

Original languageEnglish (US)
Pages (from-to)879-894
Number of pages16
JournalPostgraduate medicine
Volume133
Issue number8
DOIs
StatePublished - 2021

Keywords

  • acetaminophen
  • mechanism of action
  • nerve growth factor
  • nonsteroidal anti-inflammatory drugs
  • opioids
  • Osteoarthritis
  • pain

ASJC Scopus subject areas

  • Medicine(all)

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