The Australia & New Zealand Musculoskeletal Clinical Trials Network gathered this week in Adelaide for its annual scientific meeting.
An Australian-led study published by The Lancet that found the effects of opioids on back and neck pain, and musculoskeletal pain in general, were probably small to none, has been named the Australia & New Zealand Musculoskeletal Clinical Trials Network’s trial of the year.
The OPAL study was a triple-blinded, placebo-controlled randomised trial that recruited adults presenting to one of 157 primary care or emergency department sites in Sydney, with 12 weeks or less of low back or neck pain (or both) of at least moderate pain severity.
Participants were randomly assigned using statistician-generated randomly permuted blocks to guideline-recommended care plus an opioid (oxycodone–naloxone, up to 20 mg oxycodone per day orally) or guideline-recommended care and an identical placebo, for up to six weeks.
The primary outcome was pain severity at six weeks measured with the pain severity subscale of the Brief Pain Inventory (10-point scale), analysed in all eligible participants who provided at least one post-randomisation pain score, by use of a repeated measures linear mixed model.
This study found there was no benefit of an opioid compared with placebo in people receiving guideline care for acute non-specific low back pain or neck pain. No significant difference was found in pain severity at the primary timepoint; however the researchers could not exclude a small benefit favouring placebo.
The difference in pain scores between the groups increased over time until week 52, at which time there was a small but significant difference favouring placebo.
“Our findings support the results from other studies and reviews on similar populations, which found that the effects of opioids on back and neck pain, and musculoskeletal pain in general, were probably small to none,” the authors wrote.
“Our findings also go further to say that not only are opioids not going to benefit individuals with back and neck pain, but they might also cause worse outcomes even after short-term judicious use.”
The ANZMUSC’s annual clinical trial award capped off what chair Professor Rachelle Buchbinder described as a highly successful annual scientific meeting, held in Adelaide.
“It’s been fantastic,” she told Rheumatology Republic after the morning session on the first day of the meeting.
“People are buzzing already. Usually they’re buzzing on the second day. It’s amazing – lots of new ideas, and really interesting novel things that people were discussing.
“It’s really fantastic. We’ve got over 400 members now, so it’s growing, and it’s now not just trials. We’ve got the whole spectrum of research in our group now.”
Professor Buchbinder said highlights included an early career workshop with more than 70 people, a public lecture that highlighted three big trials that were published in the last 12 months in major journals.
“We had over 1000 people registered to come to the meeting, either online or in person, and that was also fantastic, and lots of general public consumers came talking about our work as well which was great,” she told RR.
Delegates also discussed the development of an E-learning course specifically for musculoskeletal trialists, and that’s led by the some of the early career researchers.
Professor Buchbinder said that when completed the course would be offered as open access around the world.
