Table 1.

Guideline recommendations for most commonly used oral and topical pharmacological agents in osteoarthritis treatment.

Guideline Author	Year of Issue	Acetaminophen	Opioid Analgesics		Peroral NSAIDs	SYSADOA	Topical NSAIDs
			Tramadol	Other
AAOS	2013	Unable to give any recommendation	Positive recommendation	Inconclusive	Positive recommendation	Strong recommendation against use	Positive recommendation
ACR/AF	2020	Conditional recommendation for	Conditional recommendation for	Conditional recommendation against	Recommended as first-line treatment	Strong recommendation against use	Strong recommendation for use prior to oral NSAIDs
OARSI	2019	Conditional recommendation against	Strong recommendation against		Recommended as first-line treatment	Not included	Recommended as first-line treatment
ESCEO	2019	Weak recommendation against as single therapy, should be used as rescue medicine in addition to first-line treatment with SYSADOA	Conditional recommendation for as third-line treatment		Recommended as first-line, short-term treatment	Recommended as first-line, long-term treatment for pharmaceutical-grade products	Recommended in addition to SYSADOA and acetaminophen prior to oral NSAIDs

AAOS—American Academy of Orthopedic Surgeons; ACR/AF—American College of Rheumatology/Arthritis Foundation; OARSI—Osteoarthritis Research Society International; ESCEO—European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases; NSAIDs—nonsteroidal anti-inflammatory drugs; SYSADOA—systemic slow-acting drugs in osteoarthritis.