Review of updated clinical guidelines for the treatment of patients with osteoarthritis: focus on the topical nonsteroidal anti-inflammatory drugs

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Abstract

Osteoarthritis (OA) is a chronic, progressive disease that usually affects the hands, knee and hip joints, causing severe pain and significantly reducing the quality of life of patients. Topical non-steroidal anti-inflammatory drugs (NSAIDs) are widely represented in international guidelines as the first step of anti-inflammatory therapy for OA. Thus, the American College of Rheumatology (ACR) strongly recommends topical NSAIDs for patients with knee OA and conventionally for patients with hand OA. In accordance with the principle that drugs with the least systemic effect are preferred, topical NSAIDs are the first step in anti-inflammatory therapy for OA of these localizations. In addition, ACR recommends that people age 75 and older use topical rather than oral NSAIDs; elderly patients often have comorbidities and/or an increased risk for cardiovascular, gastrointestinal, or renal complications. The Osteoarthritis Research Society International (OARSI) classifies the use of topical NSAIDs as a recommendation of the highest level (1A). This method is strongly recommended for patients with knee OA without concomitant diseases and with concomitant diseases of the gastrointestinal tract or cardiovascular system. Topical NSAIDs are recommended more strongly than all oral analgesics due to their favorable balance of efficacy and tolerability.

About the authors

Elena Iu. Pogozheva

Nasonova Research Institute of Rheumatology

Email: dr.pogozheva@gmail.com
канд. мед. наук, науч. сотр Moscow, Russia

Vera N. Amirdzhanova

Nasonova Research Institute of Rheumatology

д-р мед. наук, вед. науч. сотр. Moscow, Russia

Andrey E. Karateev

Nasonova Research Institute of Rheumatology

д-р мед. наук, рук. лаб. патофизиологии боли и полиморфизма скелетно-мышечных заболеваний Moscow, Russia

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