Pharmacological Treatment Of Osteoarthritis In A Nutshell

Abstract

Osteoarthritis, an inflammatory, degenerative disease of joints mostly affects weight bearing joints in old age. Treatment modalities are categorized into non-pharmacological, pharmacological and surgical. Among pharmacological options, oral formulations are mostly used. Acetaminophen is considered as first line though, NSAIDs are well established choice for the management of osteoarthritis and mostly employed for the same. However NSAIDs are associated with gastric adverse effects. Symptomatic slow acting osteoarthritis drugs like glucosamine, chondroitin sulfate, diacerein and avocado soybean saponifiables are considered as maintenance therapy as they have shown to reserve joint space width. Topical formulations are good for patients with co-morbidities. For patient not responding to other modalities, opioids and duloxetine are employed but with caution. Intra-articular injections like corticosteroids, hyaluronic acid and Platelet rich plasma are ranked highest in efficacy. Newer agents like Nerve growth factor- inhibitors, Interleukin-1 antagonists and certain neutraceutical preparations are under investigation for osteoarthritis management.