Department of Rheumatology, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
Department of Rheumatology, Beijing Hospital, Beijing, China.
Aging Clin Exp Res. 2021 Aug;33(8):2141-2147. doi: 10.1007/s40520-021-01906-y. Epub 2021 Jun 29.
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 from 2014, but in 2019 an update was published. Based on this algorithm, a Working Group (WG), including ESCEO members and Chinese experts, wished to see how the new ESCEO algorithm was perceived by Chinese experts in knee OA and how it was integrated into their clinical practice.
A WG was held between members of the international ESCEO task force and a group of Chinese experts.
Non-pharmacological approach should be combined with pharmacological interventions. In step 1, symptomatic slow-acting drugs for osteoarthritis (SYSADOA) are the most important background drugs. Evidence, supported by high-quality research, is available only for crystalline glucosamine sulfate (pCGS) and chondroitin sulfate. Topical NSAIDs could be used as an additional option. In step 2, oral NSAIDs could be useful, but cardiovascular/renal/gastrointestinal profiles of the patients should be considered. Intra-articular hyaluronic acid and corticosteroids are alternative to oral NSAIDs, but the evidence is still limited. If steps 1 and 2 are not sufficient, weak opioids could be used. Overall, the conclusions of the ESCEO algorithm are accepted in China for products available in this country. The WG suggests the importance of economic studies, specifically made in China.
This work provides evidence-based advice to establish a treatment algorithm in knee OA, for practical implementation in clinical practice in China.
欧洲临床和经济骨质疏松、关节炎和肌肉骨骼疾病学会（ESCEO）的膝关节骨关节炎（OA）管理算法自 2014 年起在全球范围内适用，但在 2019 年进行了更新。基于该算法，一个工作组（WG），包括 ESCEO 成员和中国专家，希望了解中国膝关节 OA 专家对新 ESCEO 算法的看法，以及该算法如何融入他们的临床实践。
WG 由国际 ESCEO 工作组的成员和一组中国专家举行。
应将非药物治疗方法与药物干预相结合。在第 1 步中，治疗骨关节炎的症状缓解慢作用药物（SYSADOA）是最重要的背景药物。只有高质量研究提供了结晶氨基葡萄糖硫酸盐（pCGS）和硫酸软骨素的证据。局部非甾体抗炎药（NSAIDs）可以作为额外的选择。在第 2 步中，口服 NSAIDs 可能有用，但应考虑患者的心血管/肾脏/胃肠道状况。关节内透明质酸和皮质类固醇是口服 NSAIDs 的替代药物，但证据仍然有限。如果第 1 步和第 2 步不够，可使用弱阿片类药物。总的来说，中国接受了 ESCEO 算法的结论，适用于该国可用的产品。WG 建议进行经济研究，特别是在中国进行的经济研究。
这项工作为在中国临床实践中建立膝关节 OA 治疗算法提供了循证建议。
