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American Association of Orthopaedic Surgeons (AAOS) 2013 [33]
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• Knee OA: Strongly recommend oral or topical NSAIDs or tramadol for the pharmacologic management of patients with symptomatic OA of the knee
|
|
American College of Rheumatology (ACR) 2012 [9]
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• Hand OA: Initial management of hand OA should include one
|
|
• or more of the following:
|
|
o topical capsaicin
|
|
o topical NSAIDs, including trolamine salicylate
|
|
o oral NSAIDs, including COX-2 inhibitors
|
|
o tramadol
|
|
• Knee OA: Initial management of knee OA should include one
|
|
• of the following:
|
|
o acetaminophen
|
|
o oral NSAIDs
|
|
o topical NSAIDs
|
|
o tramadol
|
|
o intra-articular corticosteroid injections
|
|
• Topical rather than oral NSAIDs should be used in patients with hand or knee OA aged ≥75 years
|
|
American Geriatric Society (AGS) 2009 [35]
|
• Localized, non-neuropathic persistent pain: Patients with localized, non-neuropathic persistent pain may be candidates for topical NSAIDs
|
|
American Pain Society (APS) 2002 [34]
|
• Guidelines were published prior to FDA approval of topical NSAIDs
|
|
European League Against Rheumatism (EULAR) 2003, 2007 [10, 36]
|
• Hand OA: Topical treatments are recommended over systemic treatments, especially for mild to moderate pain and when only a few joints are affected
|
|
• Hand or Knee OA: Topical NSAIDs and capsaicin have clinical efficacy and are safe in the treatment of hand or knee OA
|
|
National Institute for Health and Clinical Excellence (NICE, United Kingdom) 2008 [11]
|
• Hand or Knee OA:
|
|
o Topical NSAIDs should be considered for pain relief in addition to nonpharmacologic treatment
|
|
o Topical NSAIDs and/or acetaminophen should be considered ahead of oral NSAIDs, COX-2 inhibitors, or opioids
|
|
Osteoarthritis Research Society International (OARSI) 2008 [12]
|
• Knee OA: Topical NSAIDs and capsaicin may be effective as adjunctives and alternatives to oral analgesics/anti-inflammatory agents in patients with knee OA
|
