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A consensus statement on the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) algorithm for the management of knee osteoarthritis-From evidence-based medicine to the real-life setting

2016-02-01Artigo científico Acesso aberto
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dc.contributor.authorBruyère, Olivier
dc.contributor.authorCooper, Cyrus
dc.contributor.authorPelletier, Jean Pierre
dc.contributor.authorMaheu, Emmanuel
dc.contributor.authorRannou, François
dc.contributor.authorBranco, Jaime
dc.contributor.authorBranco, Jaime
dc.contributor.authorLuisa Brandi, Maria
dc.contributor.authorKanis, John A.
dc.contributor.authorAltman, Roy D.
dc.contributor.authorHochberg, Marc C.
dc.contributor.authorMartel-Pelletier, Johanne
dc.contributor.authorReginster, Jean Yves
dc.contributor.institutionCentro de Estudos de Doenças Crónicas (CEDOC)
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblElsevier
dc.date.accessioned2025-11-11T22:05:12Z
dc.date.available2025-11-11T22:05:12Z
dc.date.issued2016-02-01
dc.descriptionFunding Information: All authors meet the ICMJE criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published.Editorial assistance in the preparation of this article was provided by Lisa Buttle, PhD, of Medscript Ltd., which was funded by the ESCEO asbl, Belgium. Publisher Copyright: © 2015 The Authors.
dc.description.abstractThe European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) published a treatment algorithm for the management of knee osteoarthritis (OA) in 2014, which provides practical guidance for the prioritization of interventions. Further analysis of real-world data for OA provides additional evidence in support of pharmacological interventions, in terms of management of OA pain and function, avoidance of adverse events, disease-modifying effects and long-term outcomes, e.g., delay of total joint replacement surgery, and pharmacoeconomic factors such as reduction in healthcare resource utilization. This article provides an updated assessment of the literature for selected interventions in OA, focusing on real-life data, with the aim of providing easy-to-follow advice on how to establish a treatment flow in patients with knee OA in primary care clinical practice, in support of the clinicians' individualized assessment of the patient. In step 1, background maintenance therapy with symptomatic slow-acting drugs for osteoarthritis (SYSADOAs) is recommended, for which high-quality evidence is provided only for the prescription formulations of patented crystalline glucosamine sulfate and chondroitin sulfate. Paracetamol may be added for rescue analgesia only, due to limited efficacy and increasing safety signals. Topical non-steroidal anti-inflammatory drugs (NSAIDs) may provide additional symptomatic treatment with the same degree of efficacy as oral NSAIDs without the systemic safety concerns. Oral NSAIDs maintain a central role in step 2 advanced management of persistent symptoms. However, oral NSAIDs are highly heterogeneous in terms of gastrointestinal and cardiovascular safety profile, and patient stratification with careful treatment selection is advocated to maximize the risk:benefit ratio. Intra-articular hyaluronic acid as a next step provides sustained clinical benefit with effects lasting up to 6 months after a short-course of weekly injections. As a last step before surgery, the slow titration of sustained-release tramadol, a weak opioid, affords sustained analgesia with improved tolerability.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent430619
dc.identifier.doi10.1016/j.semarthrit.2015.11.010
dc.identifier.issn0049-0172
dc.identifier.otherPURE: 135216413
dc.identifier.otherPURE UUID: 45db300d-4683-47e9-9017-5780df2561cc
dc.identifier.otherScopus: 84958118927
dc.identifier.otherPubMed: 26806188
dc.identifier.otherWOS: 000371652400002
dc.identifier.urihttp://hdl.handle.net/10362/190554
dc.identifier.urlhttps://www.scopus.com/pages/publications/84958118927
dc.language.isoeng
dc.peerreviewedyes
dc.subjectChondroitin
dc.subjectGlucosamine
dc.subjectHyaluronic acid
dc.subjectKnee osteoarthritis
dc.subjectNon-steroidal anti-inflammatory drugs
dc.subjectSymptomatic slow-acting drugs for osteoarthritis (SYSADOAs)
dc.subjectTramadol
dc.subjectRheumatology
dc.subjectAnesthesiology and Pain Medicine
dc.titleA consensus statement on the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) algorithm for the management of knee osteoarthritis-From evidence-based medicine to the real-life settingen
dc.typejournal article
degois.publication.firstPageS3
degois.publication.issue4
degois.publication.lastPageS11
degois.publication.titleSeminars in Arthritis and Rheumatism
degois.publication.volume45
dspace.entity.typePublication
person.familyNameBranco
person.givenNameJaime
person.identifier.ciencia-idB612-E5C3-60DC
person.identifier.orcid0000-0001-7024-4375
person.identifier.scopus-author-id8417815400
rcaap.rightsopenAccess
relation.isAuthorOfPublication4caea9f3-40dd-4c95-98ec-0120509287c0
relation.isAuthorOfPublication.latestForDiscovery4caea9f3-40dd-4c95-98ec-0120509287c0

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