medwireNews: Updated evidence-based guidelines for the management of hand, hip, and knee osteoarthritis (OA) in the USA have been issued by the ACR and the Arthritis Foundation.
These recommendations “are based on the best available evidence of benefit, safety, and tolerability of physical, educational, behavioral, psychosocial, mind-body, and pharmacologic interventions, as well as the consensus judgment of clinical experts,” say Sharon Kolasinski (University of Pennsylvania, Philadelphia, USA) and co-authors.
The guidelines, published simultaneously in Arthritis & Rheumatology and Arthritis Care & Research, provide strong recommendations for nonpharmacologic management – including exercise, cane use, hand orthoses when needed, and weight loss for overweight or obese individuals – as well as for pharmacologic options including nonsteroidal anti-inflammatory drugs and intraarticular glucocorticoid injections for knee OA.
Kolasinski and colleagues note that “[t]he choice of any single or group of interventions may vary over the course of the disease or with patient and provider preferences, and is optimally arrived at through shared decision-making,” emphasizing that their recommendations “should not be used to limit or deny access to therapies.”
They point out that a “large research agenda remains to be addressed,” as no disease-modifying agents for OA are available at present.
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Arthritis Rheumatol 2020; doi:10.1002/art.41142
Arthritis Care Res 2020; doi:10.1002/acr.24131