Clinical evidence for osteoarthritis as an inflammatory disease.

Osteoarthritis (OA) is not a simple consequence of "wear and tear" or aging--the presence of cytokines suggests a role for inflammation. OA is polyarticular in most patients, with metabolic and differential risk factors for prevalence and severity. Odds ratios for the prevalence of OA according to formal education levels are similar to those seen for dysregulatory diseases such as hypertension, diabetes, and rheumatoid arthritis. Clinical survey data indicate significant patient preference for nonsteroidal anti-inflammatory drugs (NSAIDs) compared with acetaminophen. A recent crossover clinical trial indicated significantly greater efficacy of the NSAID, diclofenac/misoprostol, versus acetaminophen for most patients with OA.