Olivier Bruyère1, Germain Honvo2, Nicola Veronese3, Nigel K Arden4, Jaime Branco5, Elizabeth M Curtis6, Nasser M Al-Daghri7, Gabriel Herrero-Beaumont8, Johanne Martel-Pelletier9, Jean-Pierre Pelletier9, François Rannou10, René Rizzoli11, Roland Roth12, Daniel Uebelhart13, Cyrus Cooper14, Jean-Yves Reginster15. 1. Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman, 4000, Liège, Belgium; WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium. Electronic address: olivier.bruyere@uliege.be. 2. Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman, 4000, Liège, Belgium; WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium. 3. Nicola Veronese: National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy. 4. Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, University of Oxford, Oxford, UK; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK. 5. CEDOC, NOVA Medical School, Universidade Nova de Lisboa, Department of Rheumatology, CHLO, Hospital Egas Moniz, Lisbon, Portugal. 6. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK. 7. Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia. 8. Department of Rheumatology, Bone and Joint Research Unit, Fundación Jiménez Diaz, Universidad Autonoma, Madrid, Spain. 9. Division of Rheumatology, University of Montreal Hospital Centre (CHUM), Osteoarthritis Research Unit, CHUM Research Centre (CRCHUM), Montreal, Quebec, Canada. 10. Division of Physical Medicine and Rehabilitation, Department of Rheumatology, AP-HP Cochin Hospital, Université Paris Descartes Sorbonne Paris Cité, and INSERM U1124, France. 11. WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium; Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland. 12. Max-Reger-Strasse 17-19, 45128, Essen-Suedviertel, Germany. 13. Division of Musculoskeletal, Internal Medicine and Oncological Rehabilitation, Department of Orthopaedics and Traumatology, Hôpital du Valais (HVS), Centre Hospitalier du Valais Romand (CHVR), CVP, 3963, Crans-Montana, Switzerland. 14. WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK; NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK. 15. Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman, 4000, Liège, Belgium; WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium; Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia.
Abstract
OBJECTIVES: The European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) sought to revisit the 2014 algorithm recommendations for knee osteoarthritis (OA), in light of recent efficacy and safety evidence, in order to develop an updated stepwise algorithm that provides practical guidance for the prescribing physician that is applicable in Europe and internationally. METHODS: Using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) process, a summary of evidence document for each intervention in OA was provided to all members of an ESCEO working group, who were required to evaluate and vote on the strength of recommendation for each intervention. Based on the evidence collected, and on the strength of recommendations afforded by consensus of the working group, the final algorithm was constructed. RESULTS: An algorithm for management of knee OA comprising a stepwise approach and incorporating consensus on 15 treatment recommendations was prepared by the ESCEO working group. Both "strong" and "weak" recommendations were afforded to different interventions. The algorithm highlights the continued importance of non-pharmacological interventions throughout the management of OA. Benefits and limitations of different pharmacological treatments are explored in this article, with particular emphasis on safety issues highlighted by recent literature analyses. CONCLUSIONS: The updated ESCEO stepwise algorithm, developed by consensus from clinical experts in OA and informed by available evidence for the benefits and harms of various treatments, provides practical, current guidance that will enable clinicians to deliver patient-centric care in OA practice.
OBJECTIVES: The European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) sought to revisit the 2014 algorithm recommendations for knee osteoarthritis (OA), in light of recent efficacy and safety evidence, in order to develop an updated stepwise algorithm that provides practical guidance for the prescribing physician that is applicable in Europe and internationally. METHODS: Using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) process, a summary of evidence document for each intervention in OA was provided to all members of an ESCEO working group, who were required to evaluate and vote on the strength of recommendation for each intervention. Based on the evidence collected, and on the strength of recommendations afforded by consensus of the working group, the final algorithm was constructed. RESULTS: An algorithm for management of knee OA comprising a stepwise approach and incorporating consensus on 15 treatment recommendations was prepared by the ESCEO working group. Both "strong" and "weak" recommendations were afforded to different interventions. The algorithm highlights the continued importance of non-pharmacological interventions throughout the management of OA. Benefits and limitations of different pharmacological treatments are explored in this article, with particular emphasis on safety issues highlighted by recent literature analyses. CONCLUSIONS: The updated ESCEO stepwise algorithm, developed by consensus from clinical experts in OA and informed by available evidence for the benefits and harms of various treatments, provides practical, current guidance that will enable clinicians to deliver patient-centric care in OA practice.
Authors: Angelo Boffa; Davide Previtali; Giorgio Di Laura Frattura; Francesca Vannini; Christian Candrian; Giuseppe Filardo Journal: Int Orthop Date: 2020-07-09 Impact factor: 3.075
Authors: Yang Shao; Xiaoyan Zhao; Yu Zhai; Junfeng Yang; Shanfu Wang; Lei Liu; Jianwei Wang Journal: Ir J Med Sci Date: 2019-11-15 Impact factor: 1.568