Abstract:
Osteoarthritis, an inflammatory, degenerative disease of joints mostly affects weight bearing joints in old age. Treatment
modalities are categorized into non-pharmacological, pharmacological and surgical. Among pharmacological options, oral
formulations are mostly used. Acetaminophen is considered as first line though, NSAIDs are well established choice for
the management of osteoarthritis and mostly employed for the same. However NSAIDs are associated with gastric adverse
effects. Symptomatic slow acting osteoarthritis drugs like glucosamine, chondroitin sulfate, diacerein and avocado soybean
saponifiables are considered as maintenance therapy as they have shown to reserve joint space width. Topical formulations
are good for patients with co-morbidities. For patient not responding to other modalities, opioids and duloxetine are
employed but with caution. Intra-articular injections like corticosteroids, hyaluronic acid and Platelet rich plasma are ranked
highest in efficacy. Newer agents like Nerve growth factor- inhibitors, Interleukin-1 antagonists and certain neutraceutical
preparations are under investigation for osteoarthritis management.