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Wiener Medizinische Wochenschrift
Erschienen in:

01.05.2013 | main topic

Pharmacologic treatment of hand-, knee- and hip-osteoarthritis

verfasst von: Klaus Bobacz, MD

Erschienen in: Wiener Medizinische Wochenschrift | Ausgabe 9-10/2013

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Summary

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.
Vorheriger Artikel Osteoarthritis: physical medicine and rehabilitation—nonpharmacological management
Nächster Artikel Surgical management of osteoarthritis

Literatur
1.
2.
Haugen IK, Englund M, Aliabadi P, Niu J, Clancy M, Kvien TK, et al. Prevalence, incidence and progression of hand osteoarthritis in the general population: the Framingham Osteoarthritis Study. Ann Rheum Dis. 2011;70(9):1581–6.PubMedCrossRef
3.
Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum. 2008;58(1):26–35.PubMedCrossRef
4.
Lequesne M, Brandt K, Bellamy N, Moskowitz R, Menkes CJ, Pelletier JP, et al. Guidelines for testing slow acting drugs in osteoarthritis. J Rheumatol Suppl. 1994;41:65–71.PubMed
5.
Lequesne M, Brandt K, Bellamy N, Moskowitz R, Menkes CJ, Pelletier JP, et al. Guidelines for testing slow acting drugs in arthritis—addendum. J Rheumatol. 1995;22(7):1442.PubMed
6.
Mahendira D, Towheed TE. Systematic review of non-surgical therapies for osteoarthritis of the hand: an update. Osteoarthritis Cartilage. 2009;17(10):1263–8.PubMedCrossRef
7.
Zhang W, Doherty M, Leeb BF, Alekseeva L, Arden NK, Bijlsma JW, et al. EULAR evidence based recommendations for the management of hand osteoarthritis: report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2007;66(3):377–88.PubMedCrossRef
8.
Hochberg MC, Altman RD, April KT, Benkhalti M, Guyatt G, McGowan J, et al. American College of Rheumatology 2012 recommendations for the use of non-pharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken). 2012 Apr;64(4):465–74.CrossRef
9.
Ragle RL, Sawitzke AD. Nutraceuticals in the management of osteoarthritis: a critical review. Drugs Aging. 2012;29(9):717–31.PubMedCrossRef
10.
Gabay C, Medinger-Sadowski C, Gascon D, Kolo F, Finckh A. Symptomatic effects of chondroitin-4 and chondroitin-6-sulphate on hand osteoarthritis: a randomised, double-blind, placebo-controlled clinical trial at a single centre. Arthritis Rheum. 2011;63(11):3383–91.PubMedCrossRef
11.
Shin K, Kim JW, Moon KW, Yang JA, Lee EY, Song YW, et al. The efficacy of diacerein in hand osteoarthritis: a double-blind, randomized, placebo-controlled study. Clin Ther. 2013;35(4):431–9.
12.
Bahadir C, Onal B, Dayan VY, Gurer N. Comparison of therapeutic effects of sodium hyaluronate and corticosteroid injections on trapeziometacarpal joint osteoarthritis. Clin Rheumatol. 2009;28(5):529–33.
13.
Fuchs S, Monikes R, Wohlmeiner A, Heyse T. Intra-articular hyaluronic acid compared with corticoid injections for the treatment of rhizarthrosis. Osteoarthritis Cartilage. 2006;14(1):82–8.PubMedCrossRef
14.
Roux C, Fontas E, Breuil V, Brocq O, Albert C, Euller-Ziegler L. Injection of intra-articular sodium hyaluronidate (Sinovial) into the carpometacarpal joint of the thumb (CMC1) in osteoarthritis. A prospective evaluation of efficacy. Joint Bone Spine. 2007;74(4):368–72.
15.
Stahl S, Karsh-Zafrir I, Ratzon N, Rosenberg N. Comparison of intraarticular injection of depot corticosteroid and hyaluronic acid for treatment of degenerative trapeziometacarpal joints. J Clin Rheumatol. 2005;11(6):299–302.
16.
Swindells MG, Logan AJ, Armstrong DJ, Chan P, Burke FD, Lindau TR. The benefit of radiologically-guided steroid injections for trapeziometacarpal osteoarthritis. Ann R Coll Surg Engl. 2010;92(8):680–4.
17.
Heyworth BE, Lee JH, Kim PD, Lipton CB, Strauch RJ, Rosenwasser MP. Hylan versus corticosteroid versus placebo for treatment of basal joint arthritis: a prospective, randomised, double-blinded clinical trial. J Hand Surg Am. 2008;33(1):40–8.PubMedCrossRef
18.
Meenagh GK, Patton J, Kynes C, Wright GD. A randomised controlled trial of intra-articular corticosteroid injection of the carpometacarpal joint of the thumb in osteoarthritis. Ann Rheum Dis. 2004;63(10):1260–3.PubMedCrossRef
19.
Reeves KD, Hassanein K. Randomized, prospective, placebo-controlled double-blind study of dextrose prolotherapy for osteoarthritic thumb and finger (DIP, PIP, and trapeziometacarpal) joints: evidence of clinical efficacy.J Altern Complement Med. 2000;6(4):311–20.PubMedCrossRef
20.
Bacconnier L, Jorgensen C, Fabre S. Erosive osteoarthritis of the hand: clinical experience with anakinra. Ann Rheum Dis. 2009;68(6):1078–9.PubMedCrossRef
21.
Bryant LR, des Rosier KF, Carpenter MT. Hydroxychloroquine in the treatment of erosive osteoarthritis. J Rheumatol. 1995;22(8):1527–31.PubMed
22.
Magnano MD, Chakravarty EF, Broudy C, Chung L, Kelman A, Hillygus J, et al. A pilot study of tumour necrosis factor inhibition in erosive/inflammatory osteoarthritis of the hands. J Rheumatol. 2007;34(6):1323–7.PubMed
23.
Robertson CR, Rice JR, Allen NB. Treatment of erosive osteoarthritis with hydroxychloroquin. (Abstract). Arthritis Rheum. 1993;36(suppl):167.
24.
Rovetta G, Monteforte P, Molfetta G, Balestra V. A two-year study of chondroitin sulphate in erosive osteoarthritis of the hands: behaviour of erosions, osteophytes, pain and hand dysfunction. Drugs Exp Clin Res. 2004;30(1):11–6.PubMed
25.
Verbruggen G, Wittoek R, Vander CB, Elewaut D. Tumour necrosis factor blockade for the treatment of erosive osteoarthritis of the inter-phalangeal finger joints: a double blind, randomised trial on structure modification. Ann Rheum Dis. 2012;71(6):891–8.PubMedCrossRef
26.
Kon E, Filardo G, Drobnic M, Madry H, Jelic M, van DN, et al.Non-surgical management of early knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2012;20(3):436–49.PubMedCrossRef
27.
Jordan KM, Arden NK, Doherty M, Bannwarth B, Bijlsma JW, Dieppe P, et al. EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis: report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis. 2003;62(12):1145–55.PubMedCrossRef
28.
Zhang W, Moskowitz RW, Nuki G, Abramson S, Altman RD, Arden N, et al. OARSI recommendations for the management of hip and knee osteoarthritis, part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis Cartilage. 2008;16(2):137–62.PubMedCrossRef
29.
Zhang W, Nuki G, Moskowitz RW, Abramson S, Altman RD, Arden NK, et al. OARSI recommendations for the management of hip and knee osteoarthritis: part III: changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthritis Cartilage. 2010;18(4):476–99.PubMedCrossRef
30.
Wandel S, Juni P, Tendal B, Nuesch E, Villiger PM, Welton NJ, et al. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis. BMJ. 2010;341:c4675.PubMedCrossRef
31.
Christensen R, Bartels EM, Astrup A, Bliddal H. Symptomatic efficacy of avocado-soybean unsaponifiables (ASU) in osteoarthritis (OA) patients: a meta-analysis of randomised controlled trials. Osteoarthritis Cartilage. 2008;16(4):399–408.PubMedCrossRef
32.
Rintelen B, Neumann K, Leeb BF. A meta-analysis of controlled clinical studies with diacerein in the treatment of osteoarthritis. Arch Intern Med. 2006;166(17):1899–906.PubMedCrossRef
33.
Fidelix TS, Soares BG, Trevisani VF. Diacerein for osteoarthritis. Cochrane Database Syst Rev. 2006;(1):CD005117.
34.
Rutjes AW, Juni P, da Costa BR, Trelle S, Nuesch E, Reichenbach S. Viscosupplementation for osteoarthritis of the knee: a systematic review and meta-analysis. Ann Intern Med. 2012;157(3):180–91.PubMedCrossRef
35.
Zhang W, Doherty M, Arden N, Bannwarth B, Bijlsma J, Gunther KP, et al. EULAR evidence based recommendations for the management of hip osteoarthritis: report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2005;64(5):669–81.PubMedCrossRef
36.
Flanagan J, Casale FF, Thomas TL, Desai KB. Intra-articular injection for pain relief in patients awaiting hip replacement. Ann R Coll Surg Engl. 1988;70(3):156–7.PubMed
37.
Plant MJ, Borg AA, Dziedzic K, Saklatvala J, Dawes PT. Radiographic patterns and response to corticosteroid hip injection. Ann Rheum Dis. 1997;56(8):476–80.PubMedCrossRef
38.
Waseem M, Sadiq S, Gambhir AK, Lim J, Maxwell S, Bamford DJ. Safety and efficacy of intra-articular injection of the hip. Hip International. 2002;12:378–82.
39.
Fernandez Lopez JC, Ruano-Ravina A. Efficacy and safety of intra-articular hyaluronic acid in the treatment of hip osteoarthritis: a systematic review. Osteoarthritis Cartilage. 2006;14(12):1306–11.PubMedCrossRef
40.
Nguyen M, Dougados M, Berdah L, Amor B. Diacerhein in the treatment of osteoarthritis of the hip. Arthritis Rheum. 1994;37(4):529–36.PubMedCrossRef
41.
van den Bekerom MP, Lamme B, Sermon A, Mulier M. What is the evidence for viscosupplementation in the treatment of patients with hip osteoarthritis? Systematic review of the literature. Arch Orthop Trauma Surg. 2008;128(8):815–23.PubMedCrossRef
42.
Massey T, Derry S, Moore RA, McQuay HJ. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.
43.
Altman RD, Dreiser RL, Fisher CL, Chase WF, Dreher DS, Zacher J. Diclofenac sodium gel in patients with primary hand osteoarthritis: a randomised, double-blind, placebo-controlled trial. J Rheumatol. 2009;36(9):1991–9.PubMedCrossRef
44.
45.
Baraf HS, Gloth FM, Barthel HR, Gold MS, Altman RD. Safety and efficacy of topical diclofenac sodium gel for knee osteoarthritis in elderly and younger patients: pooled data from three randomised, double-blind, parallel-group, placebo-controlled, multicentre trials. Drugs Aging. 2011;28(1):27–40.PubMedCrossRef
46.
Roth SH, Fuller P. Pooled safety analysis of diclofenac sodium topical solution 1.5 % (w/w) in the treatment of osteoarthritis in patients aged 75 years or older. Clin Interv Aging. 2012;7:127–37.PubMedCrossRef
47.
Roth SH, Fuller P. Diclofenac topical solution compared with oral diclofenac: a pooled safety analysis. J Pain Res. 2011;4:159–67.PubMedCrossRef
48.
Gibbons CH, Wang N, Freeman R. Capsaicin induces degeneration of cutaneous autonomic nerve fibres. Ann Neurol. 2010;68(6):888–98.PubMedCrossRef
49.
Nolano M, Simone DA, Wendelschafer-Crabb G, Johnson T, Hazen E, Kennedy WR. Topical capsaicin in humans: parallel loss of epidermal nerve fibres and pain sensation. Pain. 1999;81(1–2):135–45.PubMedCrossRef
50.
Zhang W, Jones A, Doherty M. Does paracetamol (acetaminophen) reduce the pain of osteoarthritis? A meta-analysis of randomised controlled trials. Ann Rheum Dis. 2004;63(8):901–7.PubMedCrossRef
51.
Pincus T, Koch GG, Sokka T, Lefkowith J, Wolfe F, Jordan JM, et al. A randomised, double-blind, crossover clinical trial of diclofenac plus misoprostol versus acetaminophen in patients with osteoarthritis of the hip or knee. Arthritis Rheum. 2001;44(7):1587–98.PubMedCrossRef
52.
Pincus T, Koch G, Lei H, Mangal B, Sokka T, Moskowitz R, et al. Patient Preference for Placebo, Acetaminophen (paracetamol) or Celecoxib Efficacy Studies (PACES): two randomised, double blind, placebo controlled, crossover clinical trials in patients with knee or hip osteoarthritis. Ann Rheum Dis. 2004;63(8):931–9.PubMedCrossRef
53.
Stam W, Jansen J, Taylor S. Efficacy of etoricoxib, celecoxib, lumiracoxib, non-selective NSAIDs, and acetaminophen in osteoarthritis: a mixed treatment comparison. Open Rheumatol J. 2012;6:6–20.PubMedCrossRef
54.
O’Neil CK, Hanlon JT, Marcum ZA. Adverse effects of analgesics commonly used by older adults with osteoarthritis: focus on non-opioid and opioid analgesics. Am J Geriatr Pharmacother. 2012;10(6):331–42.CrossRef
55.
Trelle S, Reichenbach S, Wandel S, Hildebrand P, Tschannen B, Villiger PM, et al. Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis. BMJ. 2011;342:c7086.PubMedCrossRef
56.
Chan FK, Hung LC, Suen BY, Wong VW, Hui AJ, Wu JC, et al. Celecoxib versus diclofenac plus omeprazole in high-risk arthritis patients: results of a randomized double-blind trial. Gastroenterology. 2004;127(4):1038–43.PubMedCrossRef
57.
Chan FK, Lanas A, Scheiman J, Berger MF, Nguyen H, Goldstein JL. Celecoxib versus omeprazole and diclofenac in patients with osteoarthritis and rheumatoid arthritis (CONDOR): a randomised trial. Lancet. 2010;376(9736):173–9.PubMedCrossRef
58.
Nuesch E, Rutjes AW, Husni E, Welch V, Juni P. Oral or transdermal opioids for osteoarthritis of the knee or hip. Cochrane Database Syst Rev. 2009;(4):CD003115.
59.
Solomon DH, Rassen JA, Glynn RJ, Lee J, Levin R, Schneeweiss S. The comparative safety of analgesics in older adults with arthritis. Arch Intern Med. 2010;170(22):1968–76.PubMedCrossRef
60.
Wenham CY, Hensor EM, Grainger AJ, Hodgson R, Balamoody S, Dore CJ, et al. A randomised, double-blind, placebo-controlled trial of low dose oral prednisolone for treating painful hand osteoarthritis. Rheumatology (Oxford) 2012 Dec;51(12):2286–94.CrossRef
61.
Frakes EP, Risser RC, Ball TD, Hochberg MC, Wohlreich MM. Duloxetine added to oral non-steroidal anti-inflammatory drugs for treatment of knee pain due to osteoarthritis: results of a randomised, double-blind, placebo-controlled trial. Curr Med Res Opin. 2011;27(12):2361–72.PubMedCrossRef
62.
Hochberg MC, Wohlreich M, Gaynor P, Hanna S, Risser R. Clinically relevant outcomes based on analysis of pooled data from 2 trials of duloxetine in patients with knee osteoarthritis. J Rheumatol. 2012;39(2):352–8.PubMedCrossRef
63.
Reginster JY, Badurski J, Bellamy N, Bensen W, Chapurlat R, Chevalier X, et al. Efficacy and safety of strontium ranelate in the treatment of knee osteoarthritis: results of a double-blind, randomised placebo-controlled trial. Ann Rheum Dis. 2013;72(2):179–86.PubMedCrossRef
Metadaten
Titel
Pharmacologic treatment of hand-, knee- and hip-osteoarthritis
verfasst von
Klaus Bobacz, MD
Publikationsdatum
01.05.2013
Verlag
Springer Vienna
Erschienen in
Wiener Medizinische Wochenschrift / Ausgabe 9-10/2013
Print ISSN: 0043-5341
Elektronische ISSN: 1563-258X
DOI
https://doi.org/10.1007/s10354-013-0203-7

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