Second-line drug therapy for osteoarthritis

Brandt, Kenneth D.

doi:10.7861/clinmedicine.1-2-110

Cited by 5 publications

(5 citation statements)

References 11 publications

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“…Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first-line treatment for osteoarthritis [ 1 ] and a cornerstone of pharmacologic management of other arthritic and rheumatologic illnesses [ 2 ]. The dichotomous classification of patients into responders and nonresponders to NSAIDs began in the 1970s [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Definition of Nonresponse to Analgesic Treatment of Arthritic Pain: An Analytical Literature Review of the Smallest Detectable Difference, the Minimal Detectable Change, and the Minimal Clinically Important Difference on the Pain Visual Analog Scale

Stauffer¹,

Taylor

Watson

et al. 2011

International Journal of Inflammation

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Our objective was to develop a working definition of nonresponse to analgesic treatment of arthritis, focusing on the measurement of pain on the 0–100 mm pain visual analog scale (VAS). We reviewed the literature to assess the smallest detectable difference (SDD), the minimal detectable change (MDC), and the minimal clinically important difference (MCID). The SDD for improvement reported in three studies of rheumatoid arthritis was 18.6, 19.0, and 20.0. The median MDC was 25.4 for 7 studies of osteoarthritis and 5 studies of rheumatoid arthritis (calculated for a reliability coefficient of 0.85). The MCID increased with increasing baseline pain score. For baseline VAS tertiles defined by scores of 30–49, 50–65, and >65, the MCID for improvement was, respectively, 7–11 units, 19–27 units, and 29–37 units. Nonresponse can thus be defined in terms of the MDC for low baseline pain scores and in terms of the MCID for high baseline scores.

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Section: Introductionmentioning

confidence: 99%

Definition of Nonresponse to Analgesic Treatment of Arthritic Pain: An Analytical Literature Review of the Smallest Detectable Difference, the Minimal Detectable Change, and the Minimal Clinically Important Difference on the Pain Visual Analog Scale

Stauffer¹,

Taylor

Watson

et al. 2011

International Journal of Inflammation

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“…Agents that target matrix metalloproteinases, interleukin-1, or nitric oxide are being developed and are showing potential in experimental models [122][123][124]. Among these, the tetracycline group (including minocycline and doxycycline) can mitigate the side effects of arthritis, likely through cytokine-dependent actions of nitric oxide and metalloproteinases [125][126][127].…”

Section: New Anti-inflammatory Agentsmentioning

confidence: 99%

“…Many botanical preparations are purported to decrease osteoarthritic pain through anti-inflammatory actions, including ginger, tumeric, Withania sominifera, Boswellia serrata, and avocado/soybean extract [130][131][132]. In most instances, more studies are required to confirm efficacy and determine side effects [122]. Enzymes like creatine and bromelain are unlikely to be of benefit in equine osteoarthritis [115].…”

Section: New Anti-inflammatory Agentsmentioning

confidence: 99%

Managing chronic arthritis

Malone

2002

Veterinary Clinics of North America: Equine Practice

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Many compounds are being investigated for the control of symptoms of osteoarthritis in people and animals. Ideally, treatment should include analgesia, inflammation control, and chondroprotection. With further progress in this area, combination therapies tailored to the needs of the individual animal should enable us to maximize efficacy and minimize side effects. Only a few of the newer therapies and pharmaceutic agents have been investigated in the horse, however. With more rigorous investigation, they may be determined to be ineffective or unsafe. Meanwhile, as much information should be gathered from manufacturers as possible so as to ensure that appropriate recommendations are made.

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“…2 Historically, total ankle arthroplasty (TAA) has been associated with poor results and early failures with high complication rates in first-generation implants. [3][4][5] However, the development of third-generation implant designs with decreased constraint, and prosthesis-bone interface stresses, led to a progressive reduction of complications and an improvement in reproducibility and clinical outcomes. [6][7][8][9] The use of TAA from 1991 to 2010 had a relative increase of 6.71fold in the USA, along with a simultaneous 15.6% reduction of ankle arthrodesis.…”

Section: Introductionmentioning

confidence: 99%

Transfibular total ankle arthroplasty

Maccario¹,

Paoli²,

Romano

et al. 2022

The Bone & Joint Journal

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Aims This study reports updates the previously published two-year clinical, functional, and radiological results of a group of patients who underwent transfibular total ankle arthroplasty (TAA), with follow-up extended to a minimum of five years. Methods We prospectively evaluated 89 patients who underwent transfibular TAA for end-stage osteoarthritis. Patients’ clinical and radiological examinations were collected pre- and postoperatively at six months and then annually for up to five years of follow-up. Three patients were lost at the final follow-up with a total of 86 patients at the final follow-up. Results A total of 86 patients were evaluated at a mean follow-up of 65.4 months (60 to 90). At five-year follow-up, statistically significant improvements (p < 0.001) were found in the mean American Orthopaedic Foot & Ankle Society Ankle Hindfoot Score (from 33.8 (SD 14.3) to 86.1 (SD 8.8)), visual analogue scale for pain (from 8.5 (SD 1.7) to 1.5 (SD 1.2)), Short Form-12 Physical and Mental Component Scores (from 29.9 (SD 6.7) and 43.3 (SD 8.6) to 47.3 (SD 7.5) and 52.2 (SD 8.0), respectively), and mean ankle dorsiflexion and plantarflexion (from 6.2° (SD 5.5°) and 9.6° (SD 5.8°) to 23.9° (SD 7.7°) and 16.9° (SD 7.2°), respectively). Radiologically, the implants maintained neutral alignment without subsidence. Tibial or talar radiolucency was found in eight patients, but none of these patients was symptomatic. At five-year follow up, 97.7% of implants (95% confidence interval 91.2 to 99.4) were free from revision or removal with 84 implants at risk. We recorded two cases (2.3%) of failure for septic loosening. Conclusion Transfibular TAA is safe and effective with a high survival rate at mid-term follow-up and satisfactory clinical and radiological results. Further studies are required to determine the long-term performance of these implants. Cite this article: Bone Joint J 2022;104-B(4):472–478.

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Second-line drug therapy for osteoarthritis

Cited by 5 publications

References 11 publications

Definition of Nonresponse to Analgesic Treatment of Arthritic Pain: An Analytical Literature Review of the Smallest Detectable Difference, the Minimal Detectable Change, and the Minimal Clinically Important Difference on the Pain Visual Analog Scale

Definition of Nonresponse to Analgesic Treatment of Arthritic Pain: An Analytical Literature Review of the Smallest Detectable Difference, the Minimal Detectable Change, and the Minimal Clinically Important Difference on the Pain Visual Analog Scale

Managing chronic arthritis

Transfibular total ankle arthroplasty

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