Table 3.
Pharmacologic management options
| Intervention | ACR 2019 | AAOS 2021 | OARSI 2019 |
|---|---|---|---|
| Topical NSAIDs | Strongly recommended | Strongly recommended | Strongly recommend |
| Topical capsaicin | Conditionally recommended | ||
| Oral NSAIDs | Strongly recommended | Strongly recommended | Conditionally recommend (high consensus) |
| Intra-articular glucocorticoid injection | Strongly recommended | Moderately recommend | Conditionally recommend (high consensus) |
| Acetaminophen | Conditionally recommended | Strongly recommended | |
| Duloxetine | Conditionally recommended | Conditionally recommend (low consensus) | |
| Tramadol | Conditionally recommended | Strongly recommended against | |
| Non-tramadol opioids | Conditionally recommended against | Strongly recommended against | |
| Colchicine | Conditionally recommended against | ||
| Fish oil | Conditionally recommended against | Limited evidence | |
| Vitamin D | Conditionally recommended | Limited evidence | |
| Bisphosphonates | Strongly recommended against | ||
| Glucosamine | Strongly recommended against | Limited evidence | |
| Chondroitin sulfate | Strongly recommended against | Limited evidence | |
| Hydroxychloroquine | Strongly recommended against | ||
| Methotrexate | Strongly recommended against | ||
| Intra-articular hyaluronic acid injection | Conditionally recommended against | Moderately recommend against | Conditionally recommend (low consensus) |
| Intraarticular botulinum toxin Therapy | Conditionally recommended against | ||
| Prolotherapy | Conditionally recommended against | ||
| Platelet-rich plasma | Strongly recommended against | Limited Evidence | |
| Stem cell injection | Strongly recommended against | Limited Evidence | |
| Biologics (tumor necrosis factor inhibits, interleukin-1 receptor antagonists) | Strongly recommended against |