Recommendations of the French Society of Rheumatology on pharmacological treatment of knee osteoarthritis (Équipe Berenbaum)

September 16 - 2020

Jeremie Sellam, Alice Courties, Florent Eymard, Stephanie Ferrero, Augustin Latourte, Paul Ornetti, Bernard Bannwarth, Laurence Baumann, Francis Berenbaum, Xavier Chevalier, Hang Korng Ea, Marie-ChristineFabre, Romain Forestier, Laurent Grange, Henri Lellouche, Jeremy Maillet, Didier Mainard, Serge Perrot, Francois Rannou, Anne-Christine Rat, Christian H. Roux, Eric Senbel, Pascal Richette

Joint Bone Spine. 2020

OBJECTIVES: To establish recommendations for pharmacological treatment of knee osteoarthritis specific to France.

METHODS: On behalf of the French Society of Rheumatology (SFR), a bibliography group analyzed the literature on the efficacy and safety of each pharmacological treatment for knee osteoarthritis. This group joined a multidisciplinary working group to draw up recommendations. Strength of recommendation and quality of evidence level were assigned to each recommendation. A review committee gave its level of agreement.

RESULTS: Five general principles were established: 1) need to combine pharmacological and non-pharmacological treatments, 2) personalization of treatment, 3) symptomatic and/or functional aim of pharmacological treatments, 4) need to regularly re-assess the treatments and 5) discussion about arthroplasty if medical treatment fails. Six recommendations involved oral treatments: 1) paracetamol should not necessarily be prescribed systematically and/or continuously, 2) NSAIDs, possibly as first-line, 3) weak opioids, 4) strong opioids, 5) symptomatic slow-acting drugs of osteoarthritis, and 6) duloxetine (off-label use). Two recommendations involved topical agents (NSAIDs and capsaicin<1%). Three recommendations involved intra-articular treatments: corticosteroid or hyaluronic acid injections that can be proposed to patients. The experts did not draw a conclusion about the benefits of platelet-rich plasma injections.

CONCLUSION: These are the first recommendations of the SFR on the pharmacological treatment of knee osteoarthritis.

St. Antoine Hospital

Kourilsky Building
34 rue Crozatier - 75012 Paris

Sorbonne Université Medicine
Saint-Antoine Site
27 rue Chaligny - 75012 Paris

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