Abstract
Symptomatic treatment of osteoarthritis is an essential part of the complex management of OA including non-pharmacological approaches (education, regimen modification, sticks and cruthes, etc.) and symptomatic drugs with short-term efficacy (non-opiate analgesics, non-steroidal anti-inflammatory drugs) and symptom modifying slow acting drugs for OA (SYSADOA). Management must be suggested individually respecting the severity of the disease, function impairment, concomitant diseases and pharmacotherapy.
Paracetamol is analgesics of the choice in OA with maximum daily dose of 4g; only in case of insufficient response non-steroidal anti-inflammatory drugs should be given. In patients in high gastrointestinal risk it is necessary to give the NSAIDs with gastroprotective drugs (proton-pump inhibitors) or to choose selective inhibitors ox COX2.
Intra-articular glucocorticoids are also suitably in activated OA of the knee, the hip and of the hand. Slow acting drugs of OA (glucosamine sulfate, chondroitin sulfate, hyaluronan, diacerhein, ASU – avocado/soya beans unsaponifiables) are indicated to symptomatic OA patients with low or no response to paracetamol.