Skip to main content

Main menu

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • RESOURCES
    • About BJGP
    • Conference
    • Advertising
    • BJGP Life
    • eLetters
    • Librarian information
    • Alerts
    • Resilience
    • Video
    • Audio
    • COVID-19 Clinical Solutions
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers
    • RCGP e-Portfolio

User menu

  • Subscriptions
  • Alerts
  • Log in

Search

  • Advanced search
British Journal of General Practice
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers
    • RCGP e-Portfolio
  • Subscriptions
  • Alerts
  • Log in
  • Follow bjgp on Twitter
  • Visit bjgp on Facebook
  • Blog
  • Listen to BJGP podcast
Advertisement
British Journal of General Practice

Advanced Search

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • RESOURCES
    • About BJGP
    • Conference
    • Advertising
    • BJGP Life
    • eLetters
    • Librarian information
    • Alerts
    • Resilience
    • Video
    • Audio
    • COVID-19 Clinical Solutions
Article {RCT}

Nortriptyline for pain in knee osteoarthritis in general practice: a double blind randomised controlled trial

Ben Hudson, Jonathan A Williman, Lisa K Stamp, John S Alchin, Gary J Hooper, Dee Mangin, Bronwyn F Lennox Thompson and Les Toop
British Journal of General Practice 10 February 2021; BJGP.2020.0797. DOI: https://doi.org/10.3399/BJGP.2020.0797
Ben Hudson
1University of Otago Christchurch, General Practice, Christchurch, New Zealand
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jonathan A Williman
2University of Otago Christchurch, Biostatistics and Computational Biology Unit, Christchurch, New Zealand
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Lisa K Stamp
3University of Otago Christchurch, Department of Medicine, Christchurch, New Zealand
6Canterbury District Health Board, Christchurch, New Zealand
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
John S Alchin
4Canterbury District Health Board, Pain Management Centre, Christchurch, New Zealand
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Gary J Hooper
5University of Otago Christchurch, Department of Orthopaedic Surgery & Musculoskeletal Medicine, Christchurch, New Zealand
6Canterbury District Health Board, Christchurch, New Zealand
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Dee Mangin
1University of Otago Christchurch, General Practice, Christchurch, New Zealand
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Bronwyn F Lennox Thompson
5University of Otago Christchurch, Department of Orthopaedic Surgery & Musculoskeletal Medicine, Christchurch, New Zealand
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Les Toop
1University of Otago Christchurch, General Practice, Christchurch, New Zealand
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info
  • eLetters
  • PDF
Loading

Abstract

Background: Osteoarthritis (OA) of the knee is a common cause of chronic pain. The currently available analgesics have limited efficacy and may be poorly tolerated. Aim: To investigate the analgesic efficacy of nortriptyline in people with knee OA. Design and setting: A two-arm parallel-group 1:1 double blind randomised placebo-controlled trial. Participants were recruited from orthopaedic outpatient clinics, primary care, and by public advertising. Method: Adults with knee OA and with pain rated as >20 points on the 50 point Western Ontario and McMaster University (WOMAC) pain sub-scale were randomised to receive either nortriptyline or identical placebo for 14 weeks. Primary outcome was knee pain at 14 weeks measured using the WOMAC pain sub-scale. Secondary outcomes included function, stiffness, non-steroidal anti-inflammatory drug, opioid and/or paracetamol use, participant global assessment, and adverse effects at 14 weeks. Results: Of the 205 randomised participants, 201 (98%) completed follow-up at 14 weeks. The baseline-adjusted mean WOMAC pain subscale score at week 14 was 6.15 points lower (95% CI -0.26 to 12.6, p = 0.06) in the nortriptyline vs. the placebo arm. Differences in secondary outcomes generally favoured the nortriptyline arm, but were small and unlikely to be clinically relevant. Dry mouth (87% vs. 51%, p < 0.001), constipation (69% vs. 30%, p < 0.001), and sweating (31% vs. 21%, p = 0.033) were all more commonly reported by participants taking nortriptyline. Conclusion: This study suggests nortriptyline does not significantly reduce pain in people with knee OA. Adverse effect profile was as expected.

  • General practice
  • Osteoarthritis
  • Knee
  • Analgesia
  • Antidepressive Agents
  • Tricyclic
  • Randomized Controlled Trial [Publication Type]
  • Received August 25, 2020.
  • Accepted January 10, 2021.
  • Copyright © 2021, The Authors

This article is Open Access: CC BY license (https://creativecommons.org/licenses/by/4.0/)

Back to top
Previous ArticleNext Article

Online First

Download PDF
Article Alerts
Or,
sign in or create an account with your email address
Email Article

Thank you for recommending British Journal of General Practice.

NOTE: We only request your email address so that the person to whom you are recommending the page knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Nortriptyline for pain in knee osteoarthritis in general practice: a double blind randomised controlled trial
(Your Name) has forwarded a page to you from British Journal of General Practice
(Your Name) thought you would like to see this page from British Journal of General Practice.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Accepted Manuscript
Nortriptyline for pain in knee osteoarthritis in general practice: a double blind randomised controlled trial
Ben Hudson, Jonathan A Williman, Lisa K Stamp, John S Alchin, Gary J Hooper, Dee Mangin, Bronwyn F Lennox Thompson, Les Toop
British Journal of General Practice 10 February 2021; BJGP.2020.0797. DOI: 10.3399/BJGP.2020.0797

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Accepted Manuscript
Nortriptyline for pain in knee osteoarthritis in general practice: a double blind randomised controlled trial
Ben Hudson, Jonathan A Williman, Lisa K Stamp, John S Alchin, Gary J Hooper, Dee Mangin, Bronwyn F Lennox Thompson, Les Toop
British Journal of General Practice 10 February 2021; BJGP.2020.0797. DOI: 10.3399/BJGP.2020.0797
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
  • Mendeley logo Mendeley

Jump to section

  • Top
  • Article
  • Info
  • eLetters
  • PDF

Keywords

  • general practice
  • Osteoarthritis
  • Knee
  • Analgesia
  • Antidepressive Agents
  • Tricyclic
  • Randomized Controlled Trial [Publication Type]

Related Articles

Cited By...

Advertisement

BJGP Life

BJGP Open

 

@BJGPjournal's Likes on Twitter

 
 

British Journal of General Practice

NAVIGATE

  • Home
  • Current Issue
  • All Issues
  • Online First
  • Authors & reviewers

RCGP

  • BJGP for RCGP members
  • BJGP Open
  • RCGP eLearning
  • InnovAiT Journal
  • Jobs and careers
  • RCGP e-Portfolio

MY ACCOUNT

  • RCGP members' login
  • Subscriber login
  • Activate subscription
  • Terms and conditions

NEWS AND UPDATES

  • About BJGP
  • Alerts
  • RSS feeds
  • Facebook
  • Twitter

AUTHORS & REVIEWERS

  • Submit an article
  • Writing for BJGP: research
  • Writing for BJGP: other sections
  • BJGP editorial process & policies
  • BJGP ethical guidelines
  • Peer review for BJGP

CUSTOMER SERVICES

  • Advertising
  • Contact subscription agent
  • Copyright
  • Librarian information

CONTRIBUTE

  • BJGP Life
  • eLetters
  • Feedback

CONTACT US

BJGP Journal Office
RCGP
30 Euston Square
London NW1 2FB
Tel: +44 (0)20 3188 7679
Email: journal@rcgp.org.uk

British Journal of General Practice is an editorially-independent publication of the Royal College of General Practitioners
© 2021 British Journal of General Practice

Print ISSN: 0960-1643
Online ISSN: 1478-5242