New York-Presbyterian Hospital and Weill Cornell Medical College, New York City, NY, USA.
Am J Nurs. 2012 Mar;112(3 Suppl 1):S38-43. doi: 10.1097/01.NAJ.0000412650.02926.e3.
Because pain is a common and debilitating symptom of osteoarthritis in older adults, the authors reviewed data on the efficacy and safety of commonly used oral, topical, and intraarticular drug therapies in this population. A search of several databases found that most studies have focused on knee osteoarthritis and reported only short-term outcomes. Also, treatment efficacy was found to vary by drug class; the smallest effect was observed with acetaminophen and the largest with opioids and viscosupplements. Acetaminophen and topical agents had the best safety profiles, whereas oral nonsteroidal antiinflammatory drugs and opioids had the worst. Little data were available on patients ages 75 years old and older and on patients from diverse racial and ethnic groups. Most drug therapies gave mild-to-moderate pain relief; their long-term safety and efficacy and their effects in diverse populations (particularly older adults) remain undetermined.
由于疼痛是老年人骨关节炎的一种常见且使人虚弱的症状，作者回顾了该人群中常用的口服、局部和关节内药物治疗的疗效和安全性数据。对几个数据库的搜索发现，大多数研究都集中在膝关节骨关节炎上，并且只报告了短期结果。此外，药物疗效因药物类别而异；观察到的最小效果是对乙酰氨基酚，最大效果是阿片类药物和黏弹性补充剂。对乙酰氨基酚和局部制剂具有最佳的安全性，而口服非甾体抗炎药和阿片类药物的安全性最差。关于 75 岁及以上患者以及来自不同种族和族裔群体的患者的数据很少。大多数药物治疗都能轻度至中度缓解疼痛；它们的长期安全性和疗效以及它们在不同人群（尤其是老年人）中的效果仍不确定。
