Main Article Content

Mega Nilam Sari Florence Pribadi Eva M. Anigomang Gede T.W. Suara Karmila A. Wardani Kharisma A. Perdana Lidya Anin Yasmine P. Fadhilah Kevin Luke

Abstract

Introduction: Intense and severe pain is the most common symptom of acute gout arthritis (GA) flare. A recent study revealed that opioids are commonly prescribed for acute gout flare.


Objective: This review aims to explain current evidence of opioid usage in the management of pain for acute GA flare.


Method: The literature search was conducted on PubMed and Google Scholar in June 2022. Relevant articles published in the last 10 years were included.


Results: The evidence of opioid use in managing acute gout arthritis flares is scarce. Currently, no guidelines recommend opioids as an initial analgesic choice in managing acute GA flare. Opioids are indicated in the flare with severe kidney dysfunction if only oral corticosteroids and intra-articular corticosteroids are not effective in reducing pain. Conclusion: Opioids should be used as only adjuvant and last choice in selected cases.

Downloads

Download data is not yet available.

Article Details

How to Cite
Nilam Sari, M., Pribadi, F., M. Anigomang, E., T.W. Suara, G., A. Wardani, K., A. Perdana, K., Anin, L., P. Fadhilah, Y., & Luke, K. (2023). OPIOID IN THE PAIN MANAGEMENT OF ACUTE GOUT ARTHRITIS: FRIEND OR FOE?. Journal of Health Sciences, 16(01), 37–42. https://doi.org/10.33086/jhs.v16i01.3102
Section
Articles
Acute Pain, Gout Arthritis, Opioid, Analgesic, Pain Management

References

Anekar, A. A. and Cascella, M. (2022) ‘WHO Analgesic Ladder’, Journal of the Royal College of Physicians of Edinburgh, 38(3), p. 284. doi: 10.1007/978-3-642-28753-4_102537. DOI: https://doi.org/10.1007/978-3-642-28753-4_102537

Chang, A. K. et al. (2017) ‘Effect of a single dose of oral opioid and nonopioid analgesics on acute extremity pain in the emergency department: A randomized clinical trial’, JAMA - Journal of the American Medical Association, 318(17), pp. 1661–1667. doi: 10.1001/jama.2017.16190. DOI: https://doi.org/10.1001/jama.2017.16190

Dalal, D. S. et al. (2020) ‘Prescription Opioid Use Among Patients With Acute Gout Discharged From the Emergency Department’, Arthritis Care and Research, 72(8), pp. 1163–1168. doi: 10.1002/acr.23928. DOI: https://doi.org/10.1002/acr.23928

Desai, J., Steiger, S. and Anders, H. J. (2017) ‘Molecular Pathophysiology of Gout’, Trends in Molecular Medicine, 23(8), pp. 756–768. doi: 10.1016/j.molmed.2017.06.005. DOI: https://doi.org/10.1016/j.molmed.2017.06.005

FitzGerald, J. D. et al. (2020) ‘2020 American College of Rheumatology Guideline for the Management of Gout’, Arthritis care & research, 72(6), pp. 744–760. doi: 10.1002/ACR.24180. DOI: https://doi.org/10.1002/acr.24180

Jin, M. et al. (2012) ‘Uric acid, hyperuricemia and vascular diseases’, Frontiers in Bioscience, 17(2), pp. 656–669. doi: 10.2741/3950. DOI: https://doi.org/10.2741/3950

Kementerian Kesehatan RI (2022) Daftar Obat FORNAS. Available at: http://e-fornas.binfar.kemkes.go.id/index.php/front/Daftarobat/obat_fornas (Accessed: 18 June 2022).

Leung, Y. Y., Yao Hui, L. L. and Kraus, V. B. (2015) ‘Colchicine-Update on mechanisms of action and therapeutic uses’, Seminars in Arthritis and Rheumatism, 45(3), pp. 341–350. doi: 10.1016/j.semarthrit.2015.06.013. DOI: https://doi.org/10.1016/j.semarthrit.2015.06.013

Low, Qin Jian et al. (2022) ‘Management of gout in the primary care practice’, Malaysian Family Physician, 17(1). doi: 10.1007/s15006-020-9515-x. DOI: https://doi.org/10.51866/rv1165

Mikosz, C. A. et al. (2020) ‘Indication-Specific Opioid Prescribing for US Patients With Medicaid or Private Insurance, 2017’, JAMA network open, 3(5), p. e204514. doi: 10.1001/jamanetworkopen.2020.4514. DOI: https://doi.org/10.1001/jamanetworkopen.2020.4514

Nafziger, A. N. and Barkin, R. L. (2018) ‘Opioid Therapy in Acute and Chronic Pain’, Journal of Clinical Pharmacology, 58(9), pp. 1111–1122. doi: 10.1002/jcph.1276. DOI: https://doi.org/10.1002/jcph.1276

Pathan, H. and Williams, J. (2012) ‘Basic opioid pharmacology: an update’, British Journal of Pain, 6(1), pp. 11–16. doi: 10.1177/2049463712438493. DOI: https://doi.org/10.1177/2049463712438493

Perhimpunan Reumatologi Indonesia (2018) Rekomendasi Pedoman Diagnosis dan Pengelolaan Gout.

Ragab, G., Elshahaly, M. and Bardin, T. (2017) ‘Gout : An old disease in new perspective – A review’, Journal of Advanced Research, 8(5), pp. 495–511. doi: 10.1016/j.jare.2017.04.008. DOI: https://doi.org/10.1016/j.jare.2017.04.008

Richette, P. et al. (2017) ‘2016 updated EULAR evidence-based recommendations for the management of gout’, Annals of the Rheumatic Diseases, 76(1), pp. 29–42. doi: 10.1136/annrheumdis-2016-209707. DOI: https://doi.org/10.1136/annrheumdis-2016-209707

El Ridi, R. and Tallima, H. (2017) ‘Physiological functions and pathogenic potential of uric acid: A review’, Journal of Advanced Research, 8(5), pp. 487–493. doi: 10.1016/j.jare.2017.03.003. DOI: https://doi.org/10.1016/j.jare.2017.03.003

Roddy, E. et al. (2020) ‘Open-label randomised pragmatic trial (CONTACT) comparing naproxen and low-dose colchicine for the treatment of gout flares in primary care’, Annals of the Rheumatic Diseases, 79(2), pp. 276–284. doi: 10.1136/ANNRHEUMDIS-2019-216154. DOI: https://doi.org/10.1136/annrheumdis-2019-216154

Singh, J. A. and Gaffo, A. (2020) ‘Gout epidemiology and comorbidities’, Seminars in Arthritis and Rheumatism, 50(3), pp. S11–S16. doi: 10.1016/j.semarthrit.2020.04.008. DOI: https://doi.org/10.1016/j.semarthrit.2020.04.008

Skoczyńska, M. et al. (2020) ‘Pathophysiology of hyperuricemia and its clinical significance – a narrative review’, Reumatologia, 58(5), pp. 312–323. DOI: https://doi.org/10.5114/reum.2020.100140

Stewart, S. et al. (2016) ‘The first metatarsophalangeal joint in gout: A systematic review and meta-analysis’, BMC Musculoskeletal Disorders, 17(1). doi: 10.1186/s12891-016-0919-9. DOI: https://doi.org/10.1186/s12891-016-0919-9

Stewart, S. et al. (2020) ‘The experience of a gout flare: a meta-synthesis of qualitative studies’, Seminars in Arthritis and Rheumatism, 50(4), pp. 805–811. doi: 10.1016/j.semarthrit.2020.06.001. DOI: https://doi.org/10.1016/j.semarthrit.2020.06.001

Trang, T. et al. (2015) ‘Pain and poppies: The good, the bad, and the ugly of Opioid analgesics’, Journal of Neuroscience, 35(41), pp. 13879–13888. doi: 10.1523/JNEUROSCI.2711-15.2015. DOI: https://doi.org/10.1523/JNEUROSCI.2711-15.2015

Whittle, S. L. et al. (2012) ‘The efficacy and safety of opioids in inflammatory arthritis: A Cochrane systematic review’, Journal of Rheumatology, 39(SUPPL. 90), pp. 40–46. doi: 10.3899/jrheum.120341. DOI: https://doi.org/10.3899/jrheum.120341

Zhang, W. Z. (2021) ‘Why does hyperuricemia not necessarily induce gout?’, Biomolecules, 11(2), pp. 1–11. doi: 10.3390/biom11020280. DOI: https://doi.org/10.3390/biom11020280

Mega Nilam Sari

Florence Pribadi, Universitas Ciputra

Eva M. Anigomang

Gede T.W. Suara

Karmila A. Wardani

Kharisma A. Perdana

Lidya Anin

Yasmine P. Fadhilah

Kevin Luke