Beta blockers fail to show analgesic effect in knee osteoarthritis

  • Osteoarthritis Cartilage

  • de Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • A prospective cohort study nixes a link between β-blockers and pain reduction in patients with symptomatic knee osteoarthritis (KOA).

Why this matters

  • Small randomized controlled trials previously suggest that β-blockers are associated with improved analgesia in other pain conditions.

Study design

  • Multicenter prospective longitudinal observational study of symptomatic KOA in at least 1 knee (n=1168; Kellgren-Lawrence grade ≥2 with frequent pain).
  • β-blocker users were compared with other antihypertensive users (e.g., calcium channel blockers, diuretics) for pain reduction.
  • β-blocker and other medications usage was confirmed by direct examination by study personnel.
  • Funding: NIH; Merck & Co., Inc., Kenilworth, NJ, USA; Novartis Pharmaceuticals Corporation; GlaxoSmithKline; Pfizer, Inc.

Key results

  • 15% of cohort reported β-blocker use; 33% reported other antihypertensive users.
  • On Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC pain scores; range, 0-20 with higher numbers indicative of worse pain), no differences were found between β-blocker users (5.2; 95% CI, 4.7-5.8) and other antihypertensive users (4.9 [95% CI, 4.6-5.2]; within-person difference of 0.1 [95% CI, −0.3 to 0.4]).
  • No differences between β-blocker users and users of other antihypertensives in:
    • proportion reporting widespread joint pain (pain affecting both sides of the body above and below the waist), and
    • proportion with reported use of strong prescription pain medication.

Limitations

  • Observational design.