drug used in osteoarthritis

7/24/2019 Drug Used in Osteoarthritis

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Academic in Service

Osteoarthritis


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Osteoarthritis (OA)

Degenerative joint disease

disease of the entire joint involving thecartilage, joint lining, ligaments, and

underlying bone


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Osteoarthritis


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Cartilage: function

Enable movement within the required

range of motion

Distribute loading across joint tissues

Stabilize the joint during use


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Pathologic changes in OA


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Arthritis VS healthy joints


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Classification of OA

1. Primary (Idiopathic OA)

Most common

Age >50 years, women > men2. Secondary OA

Occupation, sport, trauma

Obesity Inflammatory joint disease (RA, gout)


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Distribution of primary OA


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Risk factors of osteoarthritis

Older age

Family member with OA

Obesity Previous traumatic injury or repetitive

use of joints

Joint deformity such as unequal leglength


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Signs and symptoms

Joint painand stiffness

Crackingor grinding noise with joint

movement

Swellingor tenderness in one or more

joints

Decreased function of the joint


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Diagnosis of OA (knee)


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Diagnosis of OA (hip)


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Diagnosis of OA (hand)


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Goals

Educate the patient, family members

and caregiver

Relieve pain and stiffness

Maintain or improve joint mobility

Limit functional impairment

Maintain or improve quality of life


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guideline

American college of rheumatology


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Pharmacologic treatment


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Pharmacologic treatment

Disease modifying OA drugs (DMOADs)

Structure modifying OA drugs (SMOAD)

Symptomatic slow acting drug for OA

(SYSADOA)


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Symptomatic slow acting drug for OA

(SYSADOA)

Hyaluronic acid

Glucosamine sulfate, chondrotin sulfate

Diacerein

Avocado/ soybean unsaponifiable

Tetracycline : MMP inhibitor

Recombinant human superoxide dismultase

(rH-SOD) Glycosaminoglycan polysulfuricacid,

Glycosaminoglycan-peptide complex,

pentosanpolysulfate


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SYSADOA

Not enough evidence

Not recommended combination of drugs

in this class

Help to reduce pain as well as improve

joint mobility


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Intra-articular therapy

Steroids

excellent pain relief but only used in

inflammed joints

limited to 3-4 injections per yearHyaluronic acid

Not enough evidence

Alternative therapy to those who do not

response to oral medication


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Reference

Dipiro JT, Talbert RL, Yee GC, Matake GR, Wells BG, Posey LM,

eds. (2011). Pharmacotherapy handbook. 8th ed. New York:

McGraw-Hill.

American college of Rheumatology. Osteoarthritis. Retrieved

from http://www.rheumatology.org/I-Am-A/Patient-

Caregiver/Diseases-Conditions/Osteoarthritis

Hochberg M, Altman R, April K. American college of

rheumatology 2012 recommendation s for the use of

nonpharmacologic and pharmacologic therapies in osteoarthritis

of the hand, hip, and knee. Arthritis care Res 2012;64(4): 465-74


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drug used in osteoarthritis

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