title: Pharmacologic treatment of hand-, knee- and hip-osteoarthritis.
abstract: Osteoarthritis (OA) is a joint disease of high prevalence and affects > 90 % of the population, depending on several risk factors. Symptomatic OA is less frequent, but requires an individually tailored therapeutic regimen consisting of non-pharmacological and pharmacological treatment modalities. Pharmacologic therapy, however, is mainly limited to analgetic and anti-inflammatory agents; structure modifying remedies do not exist. The therapeutic approach to hand-, knee- and hip-OA is basically similar and differs only at some minor points. Generally, topical agents or paracetamol are recommended as first-line agents. If unsuccessful oral non-steroidal anti-inflammatory drugs (NSAIDs) or COX-2-selctive inhibitors should be introduced. Tramadol is an option in the case patients will not respond satisfactorily to NSAIDs. Glucosamine and chondroitine sulphate are no longer recommended in knee and hip OA, but chondroitine might be efficient in treating hand OA. Oral NSAIDs should be prescribed with caution due to potential side effects. Opioids are not recommended as their benefits are outweighed by an increased risk for serious adverse events.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria. klaus.bobacz@meduniwien.ac.at
authors.forename: Klaus
authors.initials: K
authors.lastname: Bobacz
mesh_terms: D000082:Acetaminophen / Q000009:adverse effects / Q000627:therapeutic use; D000284:Administration, Oral; D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D002211:Capsaicin / Q000009:adverse effects / Q000627:therapeutic use; D002807:Chondroitin / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy; D052246:Cyclooxygenase 2 Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D005944:Glucosamine / Q000009:adverse effects / Q000627:therapeutic use; D050823:Hand Joints; D006801:Humans; D010003:Osteoarthritis / Q000188:drug therapy*; D015207:Osteoarthritis, Hip / Q000188:drug therapy*; D020370:Osteoarthritis, Knee / Q000188:drug therapy*; D014147:Tramadol / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000305:Adrenal Cortex Hormones; D000700:Analgesics; D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D000082:Acetaminophen; D014147:Tramadol; D002807:Chondroitin; D005944:Glucosamine; D002211:Capsaicin