Extended release hydrocodone in the management of chronic nonmalignant and non-neuropathic pain in patients with osteoarthritis

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Extended release hydrocodone in the management of chronic nonmalignant and non-neuropathic pain in patients with osteoarthritis

Osteoarthritis (OA) is the most common form of arthritis causing pain, swelling and reduced motion in the joints, mostly joints of hands, knees, hips or spine. Cartilage, the lubricious tissue that covers the end of the bones in a joint and works as a shock absorber gets detoriated in OA patients. Hydrocodone is a narcotic analgesic used to treat pain. Osteoarthritis related chronic pain is often associated with the physical and psychosocial impairment and also affects the quality of life. Although there are limited literature on long term opioid therapy, a post hoc analysis of OA patients assessed the long-term safety and effectiveness of a once-daily, single-entity, extended-release (ER) formulation of the hydrocodone (HYD).  Hydrocodone possesses abuse-deterrent properties that can alleviate the severe pain that other treatment options failed to relieve.

In this post-hoc analysis, 307 patients with OA pain were included from a primary open-label study. Screening and dose titration was performed in patients who achieved a stable HYD dose for 52 weeks of maintenance period. Supplemental non-opioid or short-acting opioid analgesics were allowed during the study.

Results of this analysis showed that no new or unexpected safety concerns were emerged during the treatment. The safety profile was reported to be consistent with other µ-opioid agonists with 22% discontinuation of treatment due to adverse events. Clinically meaningful analgesia was achieved as mean “average pain over the last 24 hours”, scores were decreased by 2.9 points from the baseline to the end of the maintenance. During the maintenance period, pain severity was declined by 2.7 points and interference by 2.5 points from baseline. Mean “pain right now” scores were same as that were at the dosing.

At the end of the study, most patients gave satisfactory feedback for treatment with HYD. Long term use of HYD for the treatment of OA has proven to be a well-tolerated and has also provided to be a clinically important analgesia.


Postgrad Med.

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Original title of article:

Hysingla® ER, a once-daily, single-entity hydrocodone with abuse-deterrent properties in treating chronic nonmalignant and nonneuropathic pain in patients with osteoarthritis.


Taber L Baldridge S He E Ripa SR. 

Postgrad Med.
Therapeutic, Hydrocodone, Osteoarthritis, Chronic, Semi-synthetic Opioid, Post Hoc Analysis, Maintenance, Efficacy, Safety, Average Pain Over The Last 24 Hours Scores, Pain Right Now Scores, Brief Pain Inventory-Short Form, Treatment Satisfaction Questionnaire
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