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Title

Evaluation of symptomatic slow-acting drugs in osteoarthritis using the GRADE system

Authors
Bruyere, Olivier
Burlet, Nansa
Delmas, Pierre D.
Cooper, Cyrus
Reginster, Jean-Yves
Published in BMC Musculoskeletal Disorders. 2008, vol. 9, p. 165
Abstract BACKGROUND: Symptomatic slow-acting drugs (SYSADOA) have been largely studied over the last decade. The objective of this study is to prepare a document providing recommendations for the use of SYSADOA in osteoarthritis (OA). METHODS: The following interventions were taken into consideration: avocado/soybean unsaponifiables, chondroitin sulfate, diacereine, glucosamine sulfate, hyaluronic acid, oral calcitonin, risedronate, strontium ranelate. Recommendations were based on the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. The GRADE system is based on a sequential assessment of the quality of evidence, followed by assessment of the balance between benefits versus downsides and subsequent judgment about the strength of recommendations. RESULTS: Chondroitin sulfate, diacereine, glucosamine sulfate, avocado/soybean unsaponifiables and hyaluronic acid have demonstrated pain reduction and physical function improvement with very low toxicity, with moderate to high quality evidence. Even if pre-clinical data and some preliminary in vivo studies have suggested that oral calcitonin and strontium ranelate could be of potential interest in OA, additional well-designed studies are needed. CONCLUSION: In the benefit/risk ratio, the use of chondroitin sulfate, diacereine, glucosamine sulfate, avocado/soybean unsaponifiables and hyaluronic acid could be of potential interest for the symptomatic management of OA.
Keywords Anthraquinones/administration & dosage/adverse effectsAntirheumatic Agents/*administration & dosage/adverse effectsCalcitonin/administration & dosage/adverse effectsChondroitin Sulfates/administration & dosage/adverse effectsClinical Trials as Topic/*statistics & numerical dataEtidronic Acid/administration & dosage/adverse effects/analogs & derivativesGlucosamine/administration & dosage/adverse effectsHumansHyaluronic Acid/administration & dosage/adverse effectsOrganometallic Compounds/administration & dosage/adverse effectsOsteoarthritis/*drug therapyOutcome Assessment (Health Care)/methodsPlant Extracts/administration & dosage/adverse effectsThiophenes/administration & dosage/adverse effects
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PMID: 19087296
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Research group Nutrition et os (66)
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BRUYERE, Olivier et al. Evaluation of symptomatic slow-acting drugs in osteoarthritis using the GRADE system. In: BMC Musculoskeletal Disorders, 2008, vol. 9, p. 165. https://archive-ouverte.unige.ch/unige:19012

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Deposited on : 2012-03-27

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