Article

Pharmacological treatments are widely recommended in international guidelines for
management of osteoarthritis (OA). However, the use of intra-articular (IA)
therapies of diverse active drugs remains controversial. We critically reviewed
studies of the efficacy and safety of IA injections of corticosteroids (CS),
hyaluronic acid (HA), platelet-rich plasma (PRP), and botulinum toxin A (BTA) and
evidence-based international recommendations for their use in treating knee OA.
The process of article selection was unsystematic. Articles were selected on the
basis of authors' expertise, self-knowledge, and reflective practice. Only
studies assessing knee OA were included. IA CS and HA injections were
conditionally to fully recommended for treating knee OA. No recommendations have
been formulated for IA PRP or BTA. The evidence remains inconsistent and
controversial for the use of IA therapies for knee OA. The characteristics of and
selection criteria for the OA population that would likely benefit from these
therapies need to be identified. Accurately phenotyping and selecting patients is
mandatory in future randomized controlled trials. Therefore, efficacy and safety
meta-analyses should be performed, as should qualitative and sensitivity analyses
of published trial results.
CI - Copyright (c) 2016 Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS