Pharmaco: OA

Question 1

What drugs are used in OA for pain relief and/or anti-inflammatory

Answer 1

• Paracetamol
• NSAIDs
• COX-2 selective NSAIDs
• Corticosteroids

Question 2

What is a symptomatic slow-acting drug used in OA?

Answer 2

Intra-articular hyaluronic acid (HA)

Inject directly into joint capsule

• Hyaluronic acid is a large glycosaminoglycan (naturally in synovial fluid)
• Shock absorption, traumatic energy dissipation, protective coating of cartilage, lubrication, reduce pain and stiffness
• Induces biosynthesis of HA and extracellular matrix

However it is strongly recommended against for hip, and conditionally recommended against for hands and knees

Question 3

What supplements may be used, what is their evidence level?

Answer 3

• Glucosamine (strongly recommended against)
• Chondroitin sulphate (strongly recommended against for knee and hip, conditional for hand)

Inadequate and inconsistent evidence