Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman, 4000, Liège, Belgium; WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium.
Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman, 4000, Liège, Belgium; WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium.
Semin Arthritis Rheum. 2019 Dec;49(3):337-350. doi: 10.1016/j.semarthrit.2019.04.008. Epub 2019 Apr 30.
The European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) sought to revisit the 2014 algorithm recommendations for knee osteoarthritis (OA), in light of recent efficacy and safety evidence, in order to develop an updated stepwise algorithm that provides practical guidance for the prescribing physician that is applicable in Europe and internationally.
Using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) process, a summary of evidence document for each intervention in OA was provided to all members of an ESCEO working group, who were required to evaluate and vote on the strength of recommendation for each intervention. Based on the evidence collected, and on the strength of recommendations afforded by consensus of the working group, the final algorithm was constructed.
An algorithm for management of knee OA comprising a stepwise approach and incorporating consensus on 15 treatment recommendations was prepared by the ESCEO working group. Both "strong" and "weak" recommendations were afforded to different interventions. The algorithm highlights the continued importance of non-pharmacological interventions throughout the management of OA. Benefits and limitations of different pharmacological treatments are explored in this article, with particular emphasis on safety issues highlighted by recent literature analyses.
The updated ESCEO stepwise algorithm, developed by consensus from clinical experts in OA and informed by available evidence for the benefits and harms of various treatments, provides practical, current guidance that will enable clinicians to deliver patient-centric care in OA practice.
鉴于最近的疗效和安全性证据，欧洲临床和经济骨质疏松、关节炎和肌肉骨骼疾病学会（ESCEO）希望重新审视 2014 年膝关节骨关节炎（OA）的算法推荐，以制定一个更新的逐步算法，为开处方的医生提供实用指导，适用于欧洲和国际。
使用推荐评估、制定和评估（GRADE）过程，为 ESCEO 工作组的所有成员提供了每个 OA 干预措施的证据总结文件，他们需要评估并对每个干预措施的推荐强度进行投票。根据收集的证据，以及工作组共识提供的推荐强度，构建了最终的算法。
ESCEO 工作组制定了一个包含逐步方法和 15 项治疗建议共识的膝关节 OA 管理算法。不同的干预措施都给予了“强”和“弱”的建议。该算法突出了在 OA 管理过程中持续重视非药物干预的重要性。本文探讨了不同药物治疗的益处和局限性，特别强调了最近文献分析中突出的安全问题。
由 OA 临床专家共识制定、并根据各种治疗方法的益处和危害的现有证据进行信息补充的更新后的 ESCEO 逐步算法，提供了实用、最新的指导，使临床医生能够在 OA 实践中提供以患者为中心的护理。
