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OARSI – Recommendation XIV: Avoid NSAIDs for Long-Term Use

July 26, 2010

This is a continuation of our series on the Osteoarthritis Research Society International (OARSI) recommendations for the management of hip and knee osteoarthritis published in the Journal of Osteoarthritis and Cartilage.

Non-Steroidal Anti-Inflammatory Drug

Recommendation XIV

Non Steroidal Anti Inflammatory (NSAIDs) drugs should be used at the lowest effective dose but their long-term use should be avoided.

  • There is evidence that NSAIDs can be effective in reducing pain in patients with osteoarthritis of the knee and hip.
  • Evidence exists that NSAIDs are superior to acetaminophen for pain relief in patients with OA.
  • There is a lot of evidence that NSAIDs are associated with more adverse effects than acetaminophen
  • NSAIDs can cause serious gastrointestinal problems, such as ulcers, perforations and bleeds
  • Prescribers and patients should continue to use NSAIDs at the lowest effective dose for the shortest duration to control symptoms
  • Prescribers should not switch between NSAIDs without careful consideration of the overall safety profile of the products and te patient’s individual risk factors, as well as the patient’s preferences.

The research team gave this osteoarthritis treatment option a Strength of Recommendation score of 93%.

W. Zhang Ph.D., Moskowitz M.D., et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis and Cartilage. (2008) 16, 137-162.


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