Pain management in osteoarthritis using centrally acting analgesics

• Research type

  Research Study

• Full title

  Pain management in osteoarthritis using the centrally acting analgesics duloxetine and pregabalin

• IRAS ID

  81031

• Contact name

  Nidhi Sofat

• Sponsor organisation

  St George's, University of London

• Eudract number

  2011-003803-39

• ISRCTN Number

  n/a

• Research summary

  Osteoarthritis is the most common form of arthritis worldwide. Specifically, osteoarthritis of the hands affects millions of people and is a major cause of hand disability and pain. Despite this, there are currently no treatments that delay or halt the development of osteoarthritis.Pain is one of the major symptoms of osteoarthritis and pain management is an important factor to consider in the treatment of this condition. Treatments for pain in osteoarthritis consists of local injections, anti-inflammatory gels or painkillers such as paracetamol.However, most people with osteoarthritis still have pain despite these treatments. Recent scientific studies have suggested that people with hand osteoarthritis not only feel pain in their hand joints, they also appear to have increased signals in their brain pain processing pathways. At St George??s, University of London, we have been conducting studies to find out which brain regions are activated in subjects with hand osteoarthritis. We have found that certain brain regions (thalamus, insula, cingulate and somatosensory cortex) are activated during painful tasks in patients with hand osteoarthritis but not in healthy people. In this study we will investigate whether drugs that inhibit pain processing pathways in the brain can help. Patients who are still having pain despite their usual painkillers will be randomly divided into 3 groups: one group will receive a placebo, the other 2 groups will receive one of two different drugs, duloxetine or pregabalin. Participants will be assessed using questionnaires and a brain scan (functional MRI) before and after 13 weeks of taking the tablets. This study will help us to understand the ways in which people feel pain in osteoarthritis. If our trial proves successful, drugs that dampen central pain pathways could be used in combination with local pain-relieving drugs to improve treatment and reduce disability in patients with hand osteoarthritis.

• REC name

  London - Surrey Borders Research Ethics Committee

• REC reference

  12/LO/0047

• Date of REC Opinion

  25 Jan 2012

• REC opinion

  Favourable Opinion