Update to Osteoarthritis

29 Mar Update to Osteoarthritis

This update accounts for revisions made to existing clinical guidelines and will help health care providers select the safest and most effective medications with their patients. This update follows the recommendations from the 2019 American College of Rheumatology Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee[1]. Additional supporting information for this algorithm comes from American Family Physician 2018[2], American Academy of Orthopaedic Surgeons 2017[3] and 2021[4], Osteoarthritis Research Society International 2019[5], and Veterans Affairs and Department of Defense 2020[6].

The medication options were reviewed and updated based on recent guidelines and monographs for use in those with osteoarthritis of the hand, hip, or knee joints.  Meloxicam and duloxetine have been added in this update.

As always, this update includes the TreatGx standard of providing personalized dosing based on pharmacogenetics, kidney function, liver function, and drug interactions.

References

1. Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care Res (Hoboken). 2020;72(2):149-162.
2. Ebell MH. Osteoarthritis: Rapid Evidence Review. Am Fam Physician. 2018;97(8):523-526.
3. Surgeons AAoO. Management of osteoarthritis of the knee hip evidence-based clinical practice guideline. In: American Academy of Orthopaedic Surgeons; 2017.
4. Surgeons AAoO. Management of osteoarthritis of the knee (non-arthroplasty) evidence-based clinical practice guideline. In: American Academy of Orthopaedic Surgeons; 2021.
5. Bannuru RR, Osani MC, Vaysbrot EE, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578-1589.
6. Department of Veterans Affairs/Department of Defense. VA/DoD Clinical Practice Guideline for the Non-Surgical Management of Hip & Knee Osteoarthritis. 2020. https://www.healthquality.va.gov/guidelines/CD/OA/VADoDOACPG.pdf.