|The national institute for health and care excellence (NICE) has just released their updated guidelines for the management of arthritis for doctors to follow. It has some profound recommendations and implications for patients, stating treatments previously recommended for all patients with arthritis should no longer be used due to safety and lack of effectiveness.
Close to 15 % of Australians suffer from Arthritis. Osteoarthritis is by far the most common, this is sometimes referred to as “degeneration” or “wear and tear” and can be found in any joint in the body particularly areas that have suffered direct, indirect or repetitive trauma. It is most commonly found in the spine, hips and knees.
Australian Bureau of Statistics
Paracetamol (brand names Tylenol, panadol) have been routinely offered and recommended for this condition for decades, even more since the study published in the American Journal of Medicine found that approximately 107,000 patients are hospitalized each year in the US for nonsteroidal anti-inflammatory drug (NSAID)-related gastrointestinal internal bleeding and at least 16,500 NSAID-related deaths occur each yearamong arthritis patients. (NSAIDs are drugs like Ibuprofen, asprin etc)
American Journal of Medicine 1998 (Jul 27);105(1B):31–38
It was believed until now that paracetamol is relatively safe and effective however new research has proven it to be quite the opposite. Long term use is associated with increased risk of serious adverse events including increased risk of heart attack and is not clinically more effective than placebo in improving pain, stiffness or function of Arthritis.
NICE concluded that…
“No clinically important difference was demonstrated between paracetamol
3000-4000mg/day and placebo across all outcomes for knee OA and mixed joint OA (hip/knee).”
See below for excerpt from the new guidelines –