At the conference, EULAR recommendations for the treatment of osteoarthritis (OA) of the knee were announced. Professor M. DOUGADOS (Réne Descartes university, Paris) said that the recommendations were evidence-based and that 23 treatment modalities (pharmacological and non-pharmacological) had been investigated.
Among the final recommendations, paracetamol was said to be the first oral analgesic that should be tried and it should be used long-term if successful. If a patient was unresponsive to paracetamol (4g/day), then NSAIDs should be considered. Another recommendation was that while there was some evidence of structural modification for glucosamine and chondroitin, diacerein and hyaluronic acid, these therapies must be proven by new studies.
Dr MICHAEL DOCHERTY (University of Nottingham) said that EULAR's principal recommendations were that everyone with OA should get education about the condition and advice on appropriate exercise. Education could reduce pain and disability, although it was unknown why. Exercises should include regular aerobic activity and exercise to strengthen muscles over the affected joint.
Professor MARC HOCHBERG (University of Maryland, US) presented the revised American College of Rheumatology's guidelines on OA which he anticipated would be published in the autumn. He said that in terms of pharmacological interventions, in patients with no upper GI risk, dual COX-1/COX-2 inhibitors were recommended. COX-2 specific drugs, or the combination of dual inhibitor plus a gastroprotective agent, were recommended for patients with upper GI risk, he said.
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