Osteoarthritis Tx
Current Therapeutic Considerations in Osteoarthritis Management
Learning Objectives:
As a result of this activity, the learner will be able to
1. Identify the multiple factors that contribute to risk of gastrointestinal bleeding, stratify risk of gastrointestinal bleeding in individual patients, and implement practice guidelines that take into consideration the risk of gastrointestinal bleeding when prescribing pharmacologic therapies for patients with osteoarthritis (OA).
2. Recognize the basis for and implement the recommendation to exercise caution when prescribing nonsteroidal anti-inflammatory drugs (NSAIDs), inclusive of nonselective and cyclooxygenase (COX)-2 selective agents, for OA patients with risk factors for heart disease; to develop an individualized therapy based on cardiovascular risk while also accounting for gastrointestinal risk and the use of concomitant therapy for cardiovascular prophylaxis or treatment.
3. Be aware of and implement the recent recommendations from the Centers for Disease Control/Arthritis Foundation, the Osteoarthritis Research Society International and the American College of Rheumatology, which include exercise and weight loss if needed in the management of patients with OA, particularly of the knee and hip.
Introduction
The prevalence of osteoarthritis (OA) in the United States has risen rapidly in recent years, and this trend is expected to continue as the elderly population grows. The Centers for Disease Control and Prevention (CDC) reported that OA affected approximately 27 million Americans in 2005, which was an increase from the 21 million reported in 1990. The rates were higher in women than in men, especially among those older than 50 years of age.[1-3] In order to effectively manage OA, clinicians must be able to recognize factors that influence or complicate treatment options. Recently updated practice guidelines can help inform treatment strategies and clinical decisions, especially in patients who are deemed at risk for gastrointestinal (GI) or cardiovascular (CV) complications with nonsteroidal anti-inflammatory drug (NSAID) therapy.
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