Rinonapoli Giuseppe, Coaccioli Stefano, Panella Lorenzo
Dipartimento di Scienze Chirurgiche, s.c. Ortopedia e Traumatologia Università di Perugia, Ospedale S. Maria della Misericordia, 06100 Perugia, Italy.
Department of Medicine, Sezione di Clinica Medica e Anatomia Patologia, Terni, Italy.
J Pain Res. 2019 May 16;12:1529-1536. doi: 10.2147/JPR.S190161. eCollection 2019.
Osteoarthritis (OA) is the most prevalent joint disease in older people worldwide. Pain owing to OA is considered one of the most frequent causes of chronic pain; however, current pharmacological approaches have some limitations in terms of efficacy and safety. Of note, descending inhibitory pain pathways are often disrupted in chronic OA pain, and pharmacotherapies targeting those pathways - eg, those that block norepinephrine reuptake may be more appropriate for managing chronic pain than pure μ-opioid receptor (MOR) agonists. Tapentadol is an analgesic molecule, which combines two synergistic mechanisms of action, MOR, and norepinephrine reuptake inhibition. This narrative review will briefly discuss the mechanisms contributing to the onset and maintenance of pain in OA patients; clinical data on the use of tapentadol in this setting will then be presented and commented.
骨关节炎（OA）是全球老年人中最常见的关节疾病。OA所致疼痛被认为是慢性疼痛最常见的原因之一；然而，目前的药物治疗方法在疗效和安全性方面存在一些局限性。值得注意的是，下行抑制性疼痛通路在慢性OA疼痛中常被破坏，针对这些通路的药物治疗——例如，那些阻断去甲肾上腺素再摄取的药物可能比单纯的μ-阿片受体（MOR）激动剂更适合治疗慢性疼痛。曲马多是一种镇痛分子，它结合了两种协同作用机制，即MOR和去甲肾上腺素再摄取抑制。本叙述性综述将简要讨论导致OA患者疼痛发作和维持的机制；然后将介绍并评论曲马多在这种情况下使用的临床数据。
