Osteoarthritis as Debilitating Medical Condition: Pharmaceutical Treatment and Management-An Updated Review

Abstract

Background: Osteoarthritis (OA) is a common, debilitating condition marked by chronic pain, which significantly affects the quality of life, physical functionality, and mental health of affected individuals. While there are no disease-modifying treatments available, pain management remains a critical component of OA treatment. This review highlights the pharmacological options used for managing OA pain, evaluating their mechanisms, pharmacokinetics, potential side effects, and toxicity.

Aim: The aim of this review is to provide an updated analysis of the pharmaceutical treatments for OA, focusing on their effectiveness, safety profiles, and application in clinical practice, with an emphasis on current guidelines.

Methods: A comprehensive review of the latest clinical guidelines and recent studies was conducted to assess various pharmacological treatments for OA. Specific focus was placed on nonsteroidal anti-inflammatory drugs (NSAIDs), including both oral and topical forms, as well as other treatments like COX-2 inhibitors and duloxetine.

Results: NSAIDs, both oral and topical, remain the most commonly prescribed medications for OA pain management. Oral NSAIDs, although effective, carry risks of gastrointestinal, cardiovascular, and renal toxicity. Topical NSAIDs have a better safety profile with fewer systemic side effects and are recommended for knee OA and individuals with comorbidities. COX-2 inhibitors, while offering reduced gastrointestinal toxicity, are linked to cardiovascular risks and are not recommended for frail or Cardiovascularly compromised patients. Duloxetine is conditionally recommended for knee OA in patients with depression, offering a potential alternative to opioids in certain cases.

Conclusion: While pharmaceutical treatments, particularly NSAIDs and COX-2 inhibitors, remain central to OA pain management, their use requires careful consideration of patient-specific risk factors. Newer treatments like duloxetine offer additional options, especially for those with comorbidities, although further evidence is needed to fully support their widespread use.