Summary
Objective
To review the current state of pharmaceutical treatment recommendations for the management
of osteoarthritis.
Method
A narrative review was drafted to describe treatment guidelines, mechanism of action,
pharmacokinetics, and toxicity for nine classes of pharmaceuticals: 1) oral nonsteroidal
anti-inflammatory drugs (NSAIDs), 2) topical NSAIDs, 3) COX-2 inhibitors, 4) duloxetine,
5) intra-articular corticosteroids, 6) intra-articular hyaluronic acid, 7) acetaminophen
(paracetamol), 8) tramadol, and 9) capsaicin.
Results
In general, oral and topical NSAIDs, including COX-2 inhibitors, are strongly recommended
first-line treatments for osteoarthritis due to their ability to improve pain and
function but are associated with increased risks in patients with certain comorbidities
(e.g., heightened cardiovascular risks). Intra-articular corticosteroid injections
are generally recommended for osteoarthritis management and have relatively minor
adverse effects. Other treatments, such as capsaicin, tramadol, and acetaminophen,
are more controversial, and many updated guidelines offer differing recommendations.
Conclusion
The pharmaceutical management of osteoarthritis is a constantly evolving field. Promising
treatments are emerging, and medicines that were once considered conventional (e.g.,
acetaminophen) are gradually becoming less acceptable based on concerns with efficacy
and safety. Clinicians need to consider the latest evidence and recommendations to
make an informed decision with their patients about how to optimize treatment plans
for patients with knee, hip, polyarticular, or hand osteoarthritis.
Keywords
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Article info
Publication history
Published online: November 19, 2022
Accepted:
November 13,
2022
Received in revised form:
October 28,
2022
Received:
June 16,
2022
Identification
Copyright
© 2022 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
