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Tapentadol in the treatment of osteoarthritis: pharmacological rationale and clinical evidence

Authors Rinonapoli G, Coaccioli S, Panella L

Received 8 October 2018

Accepted for publication 27 February 2019

Published 16 May 2019 Volume 2019:12 Pages 1529—1536


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Katherine Hanlon

Giuseppe Rinonapoli,1 Stefano Coaccioli,2 Lorenzo Panella3

1Dipartimento di Scienze Chirurgiche, s.c. Ortopedia e Traumatologia Università di Perugia, Ospedale S. Maria della Misericordia, 06100 Perugia, Italy; 2Department of Medicine, Sezione di Clinica Medica e Anatomia Patologia, Terni, Italy; 3Rehabilitation Department, ASST Pini-CTO, Milan, Italy

Abstract: 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.

Keywords: osteoarthritis, pain, tapentadol

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