[Management of osteoarthritis: oral therapies].
According to the European League of Associations of Rheumatology (EULAR) and the American College of Rheumatology (ACR), acetaminophen should be used as a first-line therapy in patients with osteoarthritis, because of its safety and effectiveness. NSAID should be considered in patients unresponsive to acetaminophen, and should be prescribed at the lowest effective dose and for the shortest duration. The use of stronger analgesics, such as weak opioids and narcotic analgesics, is only indicated when other drugs, such as NSAID, have been ineffective or are contraindicated. Symptomatic slow acting drugs (avocado soybean unsaponifiable, chondroitin sulphate, diacerein, glucosamine sulphate) have mild symptomatic effects and may reduce the consumption of NSAID.
Fédération de rhumatologie, hôpital Lariboisière, 75475 Paris. pascal.richette@lrb.aphp.fr
Pascal
P
Richette
D000284:Administration, Oral; D000700:Analgesics / Q000008:administration & dosage*; D000880:Anthraquinones / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D018501:Antirheumatic Agents / Q000008:administration & dosage*; D002809:Chondroitin Sulfates / Q000008:administration & dosage; D004318:Doxycycline / Q000008:administration & dosage; D006801:Humans; D010003:Osteoarthritis / Q000188:drug therapy; D016896:Treatment Outcome
D000700:Analgesics; D000880:Anthraquinones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; C025292:diacerein; D002809:Chondroitin Sulfates; D004318:Doxycycline