Consensus Recommendations for Managing Osteoarthritic Pain with Topical NSAIDs in Asia-Pacific

Abstract

Osteoarthritis prevalence is expected to increase markedly in the Asia-Pacific region due to rapid population aging. Identifying effective and safe therapeutic options to manage osteoarthritic pain is viewed as a priority. The Asia-Pacific Experts on Topical Analgesics Advisory Board developed consensus statements for use of topical NSAIDs in musculoskeletal pain. Evidence supporting these statements in osteoarthritic pain was reviewed. Best available evidence indicates that topical NSAIDs have a moderate effect on relief of osteoarthritic pain, comparable to that of oral NSAIDs but with a better risk-to-benefit ratio. International clinical practice guidelines recommend topical NSAIDs on par with or ahead of oral NSAIDs for pain management in patients with knee and hand osteoarthritis, and as the first-line choice in persons aged ≥75 years.

The burden of musculoskeletal pain and the role of topical non-steroidal anti-inflammatory drugs (NSAIDs) in its treatment. Ten underpinning statements from a global pain faculty

“…The recent 2018 update of the EULAR (The European League Against Rheumatism) recommendations for the management of hand OA indicate that topical treatments are preferred over systemic treatments because of safety reasons and put topical NSAIDs as the treatment of choice within this category 21 Also, the 2018 Asia-Pacific expert consensus on the use of topical NSAIDs in musculoskeletal pain points out that they should be recommended as a first-line intervention for mild to moderate pain and that they have comparable efficacy to oral NSAIDs 24 .…”

Dolor en la Artrosis de Rodilla

“…La presencia de osteofitos en la misma localización de los síntomas es un factor de buen pronóstico. [41][42][43][44] El dolor nocturno aunque inusual, es otro patrón reconocido de la artrosis de rodilla, traduce afección severa de la articulación, la intensidad es mayor de 30 según la escala numérica del dolor de 0 a 100. Por otra parte, un 14,7% de los enfermos con artrosis refieren que el dolor es más intenso en horas de la noche y un 27,9% refiere que empeoran con el reposo en cama.…”

Ultraphonophoresis with a hyaluronic acid-containing gel for knee osteoarthritis with periarthritis

“…В литературе описан эффект фонофореза с препаратами, содержащими диметилсульфоксид и хондроитина сульфат [32], кетопрофен [33][34][35], пироксикам [36,37] и ряд других компонентов [34]. В последних «Рекомендациях консенсуса по борьбе с болью при ОА локальными формами НПВП в Азиатско-Тихоокеанском регионе» (Consensus recommendations for managing osteoarthritic pain with topical NSAIDs in Asia-Pacific) прямо указывается на возможность применения метода фонофореза для доставки соответствующих лекарственных веществ [38]. Однако нет данных об использовании ультрафонофореза с препаратами, содержащими ГнК, при заболеваниях суставов.…”