Osteoarthritis

TYLENOL^® Efficacy in OA

Proven analgesic efficacy—even when inflammation is present¹ 

At both 1 000 mg and 650 mg, the safety and efficacy* of TYLENOL^® has been well supported by clinical studies and decades of actual use.^7-9 

Acetaminophen is recommended by the American Geriatrics Society as a first-line therapy for persistent pain, particularly musculoskeletal pain.¹⁰ 

At 4 weeks, acetaminophen was shown to be as effective as ibuprofen for short-term, symptomatic treatment of OA pain of the knee7

^{Overall Stanford Health Assessment Questionnaire (HAQ) pain scores have a range of 0 to 3. 
By one-way analysis of variance among the 3 groups. 
No significant differences were observed between the three treatment groups.} 

Study Design 

• Randomized, double-blind  
•  184 patients with chronic grade 2 (mild) or grade 3 (moderate) OA knee pain 
•  Mean age: 55 to 57; 71% to 79% female  
•  Groups: acetaminophen 4 000 mg/day, ibuprofen 1 200 mg/day, or ibuprofen 2 400 mg/day 
•  4 weeks  
•  Outcome measures: HAQ pain scores, et al   

Long-term Acetaminophen Use in OA

An acetaminophen long-term use clinical study of subjects with OA showed no clinical evidence of liver dysfunction, even when dosed at 4 000 mg/day for up to 1 year.11 Remind your patients: Always read and follow the label. Stop and ask a doctor if pain gets worse or lasts more than 10 days.

Multimodal OA Pain Management

A regimen that includes pharmacological and non-pharmacological modalities can be effective in reducing OA pain and improving function12

• People who exercise can reduce their risk of OA disability by 43% with moderate physical activity just 3 times per week13†

• Manage weight to take pressure off the knees14 Losing 1 POUND of body weight = Losing 4 POUNDS of pressure on the knees

OA & cardiovascular disease

Patients with OA were 69% more likely to have heart disease and have a higher prevalence of cardiovascular risk factors than those without OA¹⁵

TYLENOL® won’t increase the risk of heart attack, heart failure, and stroke the way ibuprofen or naproxen sodium can²

TYLENOL® won’t interfere with aspirin heart therapy the way ibuprofen can¹⁶

References

<sup>1. Bradley JD, Brandt KD, Katz BP, Kalasinski LA, Ryan SI. Treatment of knee osteoarthritis: relationship of clinical features of joint inflammation to the response to a nonsteroidal antiinflammatory drug or pure analgesic. J Rheumatol. 1992;19(12):1950-1954.
2. FDA strengthens warning that non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) can cause heart attacks or strokes. U.S. Food and Drug Administration. Accessed March 29, 2023. https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-strengthens-warning-non-aspirin-nonsteroidal-anti-inflammatory
3. Hoftiezer JW, O’Laughlin JC, Ivey KJ. Effects of 24 hours of aspirin, Bufferin, paracetamol and placebo on normal human gastroduodenal mucosa. Gut. 1982;23(8):692-697.
4. Blot WJ, McLaughlin JK. Over the counter non-steroidal anti-inflammatory drugs and risk of gastrointestinal bleeding. J Epidemiol Biostat. 2000;5(2):137-142.
5. Naproxen. National Institutes of Health: US National Library of Medicine. September 15, 2015. Accessed March 29, 2023. https://www.nlm.nih.gov/medlineplus/druginfo/meds/a681029.html
6. Frech EJ, Go MF. Treatment and chemoprevention of NSAID-associated gastrointestinal complications. Ther Clin Risk Manag. 2009;5(1):65-73.
7. Bradley JD, Brandt KD, Katz BP, Kalasinski LA, Ryan SI. Comparison of an antiinflammatory dose of ibuprofen, an analgesic dose of ibuprofen, and acetaminophen in the treatment of patients with osteoarthritis of the knee. N Engl J Med. 1991;325(2):87-91.
8. Dalton JD, Schweinle JE. Randomized controlled noninferiority trial to compare extended release acetaminophen and ibuprofen for the treatment of ankle sprains. Ann Emerg Med. 2006;48(5):615-623.
9. Qi DS, May LG, Zimmerman B, et al. A randomized, double-blind, placebo-controlled study of acetaminophen 1000 mg versus acetaminophen 650 mg for the treatment of postsurgical dental pain. Clin Ther. 2012;34(12):2247-2258.e3.
10. American Geriatrics Society Panel on Pharmacological Management of Persistent Pain in Older Persons. Pharmacological management of persistent pain in older persons. J Am Geriatr Soc. 2009;57(8):1331-1346.
11. Temple AR, Benson GD, Zinsenheim JR, Schweinle JE. Multicenter, randomized, double-blind, active-controlled, parallel-group trial of the long-term (6-12 months) safety of acetaminophen in adult patients with osteoarthritis. Clin Ther. 2006;28(2):222-235.
12. Brander V. Changing the treatment paradigm: moving to multimodal and integrated osteoarthritis disease management. J Fam Pract. 2011;60(11):S41-S47.
13. Penninx BW, Messier SP, Rejeski WJ, et al. Physical exercise and the prevention of disability in activities of daily living in older persons with osteoarthritis. Arch Intern Med. 2001;161(19):2309-2316.
14. Messier SP, Gutenkunst DJ, Davis C, DeVita P. Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis Rheum. 2005;52(7):2026-2032.
15. Hall AJ, Stubbs B, Mamas MA, Myint PK, Smith TO. Association between osteoarthritis and cardiovascular disease: Systematic review and meta-analysis. Eur J Prev Cardiol. 2016;23(9):938-46.
16. Catella-Lawson F, Reilly MP, Kapoor SC, et al. Cyclooxygenase inhibitors and the antiplatelet effects of aspirin. N Engl J Med. 2001;345(25):1809-1817.</sup>