Fulltext

2019 revised algorithm for the management of knee osteoarthritis: the Southeast Asian viewpoint

Yeap SS 1 , Tanavalee A 2 , Perez EC 3 , Tan MP 4 , Reyes BHM 5 , Lee JK 6 Show all authors , Norhamdan MY 7 , Vista ES 8 , Chan WS 9 , Cong SB 10 , Tam PTT 11 , Kaufman JM 12 , Reginster JY 13 , Veronese N 14 , Penserga E 15

Affiliations 

  • 1 Department of Medicine, Subang Jaya Medical Centre, Subang Jaya, Selangor, Malaysia
  • 2 Department of Orthopaedics, Vinai Parkpian Orthopaedic Research Center, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Chulalongkorn University, Bangkok, 10330, Thailand
  • 3 College of Medicine De La Salle Medical Health Science Institute (DLSMHSI), Dasmariñas, Cavite, Philippines
  • 4 Ageing and Age-Associated Disorders Research Group, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 5 Department of Medicine, Philippine General Hospital-University of the Philippines College of Medicine, Manila, Philippines
  • 6 Department of Orthopedic Surgery, Beacon Hospital, Petaling Jaya, Malaysia
  • 7 Department of Orthopaedics and Traumatology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
  • 8 Rheumatology, Allergy and Immunology Center, St. Luke's Medical Center, Manila, Philippines
  • 9 Orthopaedic Surgeon of Orthopaedic Department of Centro Hospitalar Conde de Sao Januario, Macao, China
  • 10 Department of Rheumatology, 103 Military Hospital, Hanoi, Vietnam
  • 11 Rheumatology Department of 30-4 Hospital, Ho Chi Minh City, Vietnam
  • 12 Department of Endocrinology, State University of Ghent, Ghent, Belgium
  • 13 Public Health, Epidemiology and Health Economics Department, ULiège, Liège, Belgium
  • 14 Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, V.le F. Scaduto 61, 90144, Palermo, Italy. nicola.veronese@unipa.it
  • 15 College of Medicine University of the Philippines, Manila, Philippines
Aging Clin Exp Res, 2021 May;33(5):1149-1156.
PMID: 33774784 DOI: 10.1007/s40520-021-01834-x

Abstract

BACKGROUND: Since 2014, the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) algorithm for the management of knee osteoarthritis (OA) is available worldwide.

AIM: Based on this document, a Southeast Asia Working Group (SEAWG) wished to see how the new ESCEO algorithm developed in 2019 was perceived by Southeast Asian experts and how it was integrated into their clinical practice.

METHODS: A SEAWG was set up between members of the international ESCEO task force and a group of Southeast Asian experts.

RESULTS: Non-pharmacological management should always be combined with pharmacological management. In step 1, symptomatic slow-acting drugs for osteoarthritis are the main background therapy, for which high-quality evidence is available only for the formulations of patented crystalline glucosamine sulfate and chondroitin sulfate. In step 2, oral NSAIDs are a useful option, considering the cardiovascular/renal/gastrointestinal profiles of the individual patient. Intra-articular hyaluronic acid and corticosteroids are a possible alternative to oral NSAIDs, but limited evidence is available. If steps 1 and 2 do not give adequate relief of symptoms, tramadol can be used, but its safety is debated. In general, the indications of the ESCEO algorithm are important in Southeast Asian countries, but the reimbursement criteria of local health systems are an important aspect for adherence to the ESCEO algorithm.

CONCLUSION: This guidance provides evidence-based and easy-to-follow advice on how to establish a treatment algorithm in knee OA, for practical implementation in clinical practice in Southeast Asian countries.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

MeSH terms
Similar publications