The relative efficacy of topical non-steroidal anti-inflammatory drugs and capsaicin in osteoarthritis: a network meta-analysis of randomised controlled trials

Persson, Monica S M; Stocks, Joanne; Walsh, David A.; Doherty, Michael; Zhang, W.

doi:10.1016/j.joca.2018.08.008

Cited by 63 publications

(39 citation statements)

References 44 publications

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“…However, little is known about the pathogenesis of OA pain, and thus, there is a lack of targeted treatment and measures to control OA pain. Nonsteroidal anti-inflammatory drugs [3,4] and opioids [5,6] have a certain effect on relieving OA pain, but longterm use of these drugs has great side effects, and they cannot fundamentally reverse or delay the progression of the disease [7][8][9][10]. Although surgery is effective in relieving pain in patients with advanced OA, surgery itself can cause pain and increase the financial burden on the patient.…”

Section: Introductionmentioning

confidence: 99%

Relationship between Pain Behavior and Changes in KCNA2 Expression in the Dorsal Root Ganglia of Rats with Osteoarthritis

Zhao

Fan

Wang

et al. 2020

Pain Research and Management

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Objective. To investigate the relationship between pain behavior and potassium voltage-gated channel subfamily A member 2 (KCNA2) expression in dorsal root ganglia (DRGs) of rats with osteoarthritis (OA). Methods. Male Sprague-Dawley rats were randomly divided into three groups: blank control group (group C), normal saline group (group S), and group OA. Paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) were measured one day before injection and one, two, four, and six weeks after injection. At one, two, four, and six weeks after injection, pathological knee joint changes and activated transcription factor-3 (ATF-3) and KCNA2 expressions in DRGs were analyzed. Results. Compared with preinjection, PWMT and PWTL at two, four, and six weeks after injection were significantly decreased in the group OA (P<0.05 or 0.01). Compared with group C, PWMT and PWTL at two, four, and six weeks after injection were significantly decreased in the group OA (P<0.05 or 0.01). In the group OA, slight local articular cartilage surface destruction was found at week one. The cartilage surface destruction gradually developed, and the exacerbation of cartilage matrix reduction and bone hyperplasia were increasingly aggravated and eventually evolved into advanced OA in the second to sixth weeks. Compared with group C, ATF-3 expression was significantly increased, and KCNA2 expression was significantly decreased in the group OA at two, four, and six weeks after injection (P<0.05 or 0.01). Compared to baseline, ATF-3 expression was significantly increased, and KCNA2 expression was significantly decreased in the group OA (P<0.05 or 0.01). Conclusion. Pain behavior in OA rats was associated with decreased KCNA2 expression in DRGs.

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Section: Introductionmentioning

confidence: 99%

Relationship between Pain Behavior and Changes in KCNA2 Expression in the Dorsal Root Ganglia of Rats with Osteoarthritis

Zhao

Fan

Wang

et al. 2020

Pain Research and Management

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“…Topical NSAIDs and capsaicin may be beneficial. 18,19 Regarding complementary medicines, glucosamine and chondroitin sulphate are no more effective than placebo. 20,21 Fish oils and turmeric have mild anti-inflammatory effects, but there is insufficient evidence to support their use.…”

Section: Pharmaceuticalsmentioning

confidence: 99%

Symptom management for patients awaiting joint replacement surgery

Wall¹,

Johnson²,

Steiger³

2020

Aust J Gen Pract

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Background Joint replacement surgery is a highly effective treatment option for patients with severe osteoarthritis (OA) of the hip and knee when other treatments have failed. Unfortunately, as a result of the COVID-19 pandemic, a temporary suspension of non-urgent elective surgery was implemented. Thousands of patients currently awaiting hip and knee replacements have been affected. Many of these patients will present to their general practitioners for symptom management during this interim period. Objective The purpose of this article is to summarise current recommendations for the non-operative management of patients with symptomatic OA. Discussion Non-operative treatment modalities for OA include education, lifestyle modification and exercise, mass reduction, physiotherapy, orthoses, psychology, pharmaceuticals and injections. Multimodal therapy is required for patients with severe symptoms. A number of useful online resources are presented, as access to public allied health services may be limited because of the COVID-19 pandemic. OSTEOARTHRITIS (OA) of the hip and knee are common orthopaedic conditions, frequently causing pain and disability. The incidence of OA is steadily increasing. 1 Joint replacement surgery has revolutionised the management of OA but should be reserved for patients who have not responded to non-operative therapies. Joint replacement is very cost-effective and provides long-term improvements in pain, mobility and quality of life for most patients. 2,3 In Australia, more than 105,000 primary and revision hip and knee replacements were performed in 2018, and approximately 35% of these operations were performed in the public sector. 4,5 The projected burden of primary total hip and knee replacement in Australia is expected to increase by 208% and 276%, respectively, by the year 2030. 6 Unfortunately, as a result of the COVID-19 pandemic, a nationwide, temporary suspension of non-urgent elective surgery was implemented. Thousands of patients waiting for joint replacement surgery have been affected. Although the restrictions are being eased, patients may still experience delays as health services manage their waiting lists. Many affected patients will present to their general practitioners for symptom management in the interim period. The purpose of this article is to discuss non-operative management options for patients with severe OA. Although prompted by recent elective surgery suspensions, the principles presented are equally applicable to patients who are unfit for surgery, or patients using the public system who may wait 365 days for their joint replacement, according to National Categorisation Guidelines. 7

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“…Um systemische Nebenwirkung generell geringer zu halten, ist bei Patienten mit peripherer Arthritis und Osteoarthrose auch die lokale Behandlung mit Ketoprofen-oder sonstigen NSAR-haltigen Präparaten eine wichtige Alternative [48,49] und wird z.T. sogar als Erstlinientherapie empfohlen [50][51][52][53].…”

Section: Nozizeptive Schmerzen Bei Rheumatologischen Erkrankungenunclassified

Spezielle Schmerztherapie bei rheumatischen Erkrankungen

Pongratz

2020

Aktuelle Rheumatologie

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ZusammenfassungSchmerz als Hauptsymptom vieler chronisch-entzündlicher Erkrankungen stellt für den Patienten, aber auch für den behandelnden Arzt besonders in seiner chronifizierten Form eine große Herausforderung dar. Es gibt leider keine „Wunderpille“ mit der man Schmerzen für jeden gleich zuverlässig beseitigen kann. Es gibt aber viele Ansätze pharmakologischer als auch nicht-pharmakologischer Art und deren Kombination, um für den einzelnen Patienten wirksame Behandlungsstrategien zu finden. Um diese Strategien für jeden Patienten individuell optimal festzulegen, bedarf es zum einen eines fundamentierten Wissens über das Spektrum zur Verfügung stehender Mittel, zum anderen aber auch Erkenntnis darüber, wie diese sinnvoll nach Art der vorliegenden Schmerzformen einzusetzen sind. In dieser Übersicht wird beides behandelt, mit einem Fokus auf die medikamentöse Therapie von Schmerzen bei entzündlich-rheumatischen Erkrankungen. Dabei wird herausgearbeitet, dass es für die in diesem Zusammenhang relevantesten Formen des Schmerzes, akut-entzündlich nozizeptiv, neuropathisch und durch periphere und zentrale Sensibilisierung chronifizierte Schmerzen, jeweils andere wirksame Konzepte gibt.

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The relative efficacy of topical non-steroidal anti-inflammatory drugs and capsaicin in osteoarthritis: a network meta-analysis of randomised controlled trials

Cited by 63 publications

References 44 publications

Relationship between Pain Behavior and Changes in KCNA2 Expression in the Dorsal Root Ganglia of Rats with Osteoarthritis

Relationship between Pain Behavior and Changes in KCNA2 Expression in the Dorsal Root Ganglia of Rats with Osteoarthritis

Symptom management for patients awaiting joint replacement surgery

Spezielle Schmerztherapie bei rheumatischen Erkrankungen

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