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Table 1 OARSI pharmacological recommendations for the management of knee and/or hip OA

From: New horizons and perspectives in the treatment of osteoarthritis

Recommendation Strength of recommendation (%) (95% CI)
Acetaminophen (up to 4 g/day) can be an effective initial oral analgesic for the treatment of mild to moderate pain in patients with knee or hip OA. In the absence of an adequate response, or in the presence of severe pain and/or inflammation, alternative pharmacologic therapy should be considered based on relative Efficacy and safety, as well as concomitant medications and co-morbidities. 92 (88–99)
In patients with symptomatic hip or knee OA, NSAIDs should be used at the lowest effective dose but their long-term use should be avoided if possible. In patients with increased gastrointestinal risk, either a COX-2 selective agent or a nonselective NSAID with co-prescription of a PPI or misoprostol for gastroprotection may be considered, but NSAIDs, including both nonselective and COX-2 selective agents, should be used with caution in patients with cardiovascular risk factors. 93 (88–99)
  1. Reprinted from Zhang et al. [13] with permission from Elsevier. COX, cyclo-oxygenase; NSAID, nonsteroidal anti-inflammatory drug; OA, osteoarthritis; OARSI, Osteoarthritis Research Society International; PPI, proton pump inhibitor.