- For osteoarthritis in primary care, 8 effective treatments include exercise and intra-articular corticosteroids, whereas 3 ineffective treatments are glucosamine, chondroitin, and viscosupplementation.
- Findings are results of an umbrella systematic review and meta-analysis.
Why this matters
- Osteoarthritis is common in primary care.
- Results will be used to develop a clinical decision aid.
- Systematic reviews of 155 randomized controlled trials (RCTs) with a meta-analysis of responder outcomes (clinically meaningful outcomes) for 15 treatments.
- Funding: Alberta Health.
- Clinically meaningful pain relief compared with control (risk ratios; 95% CIs) included:
- Exercise: 2.36 (1.79-3.12).
- Intra-articular corticosteroids: 1.74 (1.15-2.62).
- Serotonin-norepinephrine reuptake inhibitors: 1.53 (1.25-1.87).
- Oral NSAIDs: 1.44 (1.36 -1.52).
- Glucosamine: 1.33 (1.02-1.74).
- Topical NSAIDs: 1.27 (1.16-1.38).
- Chondroitin: 1.26 (1.13-1.41).
- Viscosupplementation: 1.22 (1.12-1.33).
- Opioids: 1.16 (1.02-1.32), but not in trials longer than 4 weeks.
- No effect was found for glucosamine, chondroitin, and viscosupplementation.
- Funding of studies and length of treatment should be considered when interpreting the data.
- Some RCTs possibly overlooked.