Evaluating the Acute Effects of the Cannabinoid Dronabinol and the Opioid Hydromorphone Alone and in Combination: A Double-blind, Randomized, Placebo-controlled Trial in Knee Osteoarthritis
Authors' conclusion
Opioid and cannabinoid medications failed to produce robust analgesia in experimentally induced pain among patients with knee osteoarthritis. In contrast to preclinical studies, there was no evidence of synergistic analgesic effects by combining hydromorphone and dronabinol.
Study context
- Population
- Individuals with knee osteoarthritis (57% women; mean age 63.4 ± 6.4 yr)
- Participants
- 21 individuals
- Comparison
- Hydromorphone, dronabinol and their combination vs placebo
- Primary endpoint
- Pain outcomes (clinical pain severity and quantitative sensory testing of experimentally induced pain, e.g. pressure pain threshold, mechanical temporal summation) and physical functioning
- Follow-up
- 60, 120, 180, and 240 min after dosing
Methodological detailswithin-subject, double-blind, placebo-controlled
- Within-subject
- Double-blind
- Placebo-controlled
Primary result
As reported in the abstract
ηp 2
0.074
P = 0.029
Hydromorphone vs Dronabinol · greater pressure pain threshold analgesia
ηp 2
0.062
P = 0.045
Hydromorphone vs Placebo · greater capsaicin-sensitized mechanical temporal summation analgesia
ηp 2
0.087
P = 0.017
Hydromorphone vs Placebo · greater noncapsaicin-sensitized mechanical temporal summation analgesia
- No significant drug-related differences for clinical pain severity, thermal threshold or tolerance, temporal summation, cold pressor, conditioned pain modulation, capsaicin-induced thermal threshold, central sensitization, general pain sensitivity, or physical functioning (2-min walk, Timed Up and Go, stair climb)
- all P values > 0.05
Secondary outcomes
Working memory and subjective drug effects
- Hydromorphone impaired working memory accuracy vs all conditions and produced greater good effects than placebo
- all P ≤ 0.005
- Hydromorphone + dronabinol impaired working memory reaction time, greater high ratings vs placebo, greater drug effects vs placebo and hydromorphone
- all P < 0.05
- Dronabinol greater high ratings than hydromorphone
- P = 0.001
- No significant drug-related differences for fine motor movement, bad effects, drug liking
- all P > 0.05
Safety
- Higher nausea with hydromorphone + dronabinol than hydromorphone
- P < 0.05
- No significant drug-related differences in adverse event occurrence or severity
- P > 0.05
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →